Driving and Migraine: What to Do

There's never a good time to get a migraine headache. But it could be downright unsafe if it strikes while you’re behind the wheel. Some migraine headaches may not hurt very much. But when your pain gets bad or your vision changes, driving may be difficult or even impossible.

Possible Dangers

Many migraine symptoms -- which can come on before, during, or after an attack -- can make a dangerous mix with motor vehicles. These include:

Nausea and vomiting. It’s hard to keep your eyes safely on the road if you’re dealing with either of these problems.

Visual aura. You may see spots, have tunnel vision, or be unable to see clearly around you. Or your vision may get blurry. These vision disturbances can be hazardous.

Photophobia and phonophobia. Extreme sensitivity to light (photophobia) or sound (phonophobia) is common with migraines. This means sun glare or bright lights from other cars can make your migraines worse. So can honking horns or loud trucks.

Slower reflexes. You might feel your arms or legs move more slowly before or during a migraine. Or you might feel dopey or just a little “off,” as if your thinking is foggy. You might not be able to hit the brakes in time or have trouble steering the car.

Paralysis. A rare form of migraine called hemiplegic migraine can cause weakness on one side of the body before a headache starts. You shouldn’t drive or use any machinery if you have this type of migraine.

Dizziness/vertigo. This doesn’t happen often. But it can make you feel like the car is spinning.

Tinnitus. Ringing in the ears, or hearing sounds that aren’t there, isn’t a common migraine symptom. But it can make it hard for you to concentrate on driving.

Warning on Medications

Some migraine drugs treat your pain. Others aim to stop the headache from going on in the brain. These so-called “abortive” medications are mostly part of a class of prescription drugs called triptans.

Abortive drugs may cause side effects that may interfere with driving. You may feel tired, dizzy, or sleepy, even if your headache gets better. Talk to your doctor before you take the medicine, or before you get behind the wheel.

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What to Do

If you get migraines, that by itself shouldn’t prevent you from driving. But it’s also possible that a migraine attack can affect you seriously enough to cause accidents.

The safest action is to pull off the road as soon as you feel a migraine coming on. Call a friend or loved one to come pick you up if your headaches tend to go on a long time. Migraines usually can last from 4 hours to 3 days, so it might be awhile until you’re safe to drive again.

But if your headaches normally aren’t too bad and you usually power through an attack, it should be OK to stay on the road to your destination. Track your migraine patterns over time so you can anticipate how mild or severe your pain or other symptoms may get.

Driver's License

All 50 states allow people with migraine to drive. Some states require people with certain medical conditions, including those with insulin-dependent diabetes or seizures from epilepsy, to notify the department of motor vehicles or get a clearance from their doctor that they’re safe to drive. Migraines are not on that list.

But almost every state asks people getting or renewing their driver's license about medical conditions to evaluate their fitness for driving. So you would need to answer truthfully if your migraine ever impaired your driving.

Watch for Triggers

About 1 in 3 people with migraines can predict when a headache is coming. If you’re among those who get these early signs of migraine known as prodromes, use them as hints to stay off the road for a while.

Also, know what usually sets off your attacks. Avoid them if you plan to drive, especially long distances. Possible triggers include:

  • Lack of sleep
  • Skipping meals
  • Stressful situations
  • Certain foods and drinks, such as cheese, alcohol, chocolate, or lunchmeats
  • Bright lights
  • Loud noises
  • Smoke, perfume, or other strong odors

With caution and preparation, there’s no reason why you can’t mix migraines and safe driving.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on December 04, 2018

Sources

SOURCES:

Cleveland Clinic: “Migraine Headaches.”

Emad Estemalik, MD, section head of headache and facial pain, Center for Neurological Restoration, Cleveland Clinic.

Mayo Clinic: “Migraine.”

American Migraine Foundation: “Commonly Used Acute Migraine Treatments,” “Photophobia and Migraine,” “Tinnitus and Headache.”

National Headache Foundation: “Migraine.”

The Migraine Trust (UK): “Can I drive with migraine?”

Minnesota Department of Public Safety and Vehicle Services Division: “Medical Conditions & Your Driver’s License.”

Epilepsy Foundation; “State Driving Laws Database.”

National Highway Traffic Safety Administration: “Medical Review Practices For Driver Licensing.”

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