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Treating Your Migraine Headache

By Rachel Reiff Ellis
WebMD Feature
Reviewed by David T. Derrer, MD

You've got lots of choices to ease your painful migraine. Your doctor will want to find out more about the timing and strength of your headaches before suggesting a treatment plan for you.

Know Your Pain Patterns

Anne H. Calhoun, MD, partner and co-founder of the Carolina Headache Institute in Chapel Hill, NC, suggests you keep a daily headache diary. Record when your headaches happen and the symptoms you have with each one. This gives you and your doctor a better picture of what's going on.

"If most of the days are 'perfect' and headache days are occasional -- and only some reach criteria for migraine -- then I recommend treating early with the medication that will quickly get rid of the attack," Calhoun says.

Try taking the smallest dose that still packs a punch in relieving your pain. This will cut down on side effects. You don't want to take your medicine too often, as it may stop working altogether. It can even lead to more intense and more frequent "rebound headaches."

"In general, we recommend starting with the level of migraine treatment you need to reliably relieve the pain," Calhoun says. Choose what works, use it first, and use it fast.

Types of Treatment

Drugs used to treat migraine pain as it's happening are called acute treatments. Your doctor may recommend one of these:

Triptans. These work by narrowing your blood vessels and slowing blood flow. They're a fast-acting option for severe migraines.

"For most of the patients we see in a headache clinic, the most effective treatment is a triptan," Calhoun says.

Triptans include these drugs:

  • Almotriptan (Axert)
  • Eletriptan (Replax)
  • Frovatriptan (Frova)
  • Naratriptan (Amerge)
  • Rizatriptan (Maxalt)
  • Sumatriptan (Alsuma, Imitrex, Zecuity)
  • Zolmatriptan (Zomig)

If your migraine symptoms include vomiting, there are triptans in patches, shots, and mists.

Triptans work best if you take them within 2 hours of the start of your pain. They shouldn't be taken more than twice a week. Because triptans affect your blood vessels, they're not a good treatment option if you have high blood pressure, are pregnant, or have had a stroke.

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