Chronic Migraine: Medicine for When One Hits

Medically Reviewed by Murtaza Cassoobhoy, MD on February 13, 2023
Written by Stephanie Booth
3 min read

Besides a throbbing head, you feel sick to your stomach, throw up, or have diarrhea. The slightest sound or light makes things worse.

A diagnosis of chronic migraine means you feel like this half of each month or more. While a cure has yet to be found, you don't need to suffer. Drugs known as "acute" or "abortive" treatments can help ease your symptoms once they start.

Simple pain relievers may put a stop to mild migraines.

Some products at the store may be specifically labeled as migraine treatments. These may combine more than one pain relief medicine and often have caffeine, too, such as acetaminophen, aspirin, and caffeine.

If you have a gut issue like GERD (gastrointestinal esophageal reflux disease), ulcers, or irritable bowel syndrome, check with your doctor before you try these drugs.

Some over-the-counter (OTC) pain relievers can cause an upset stomach, bleeding, or ulcers. They may also be hard on your kidneys and liver.

Even if an OTC drug works well, you shouldn't take it often. Over time, they can cause ulcers and stomach bleeding. They can also start to give you headaches instead of relieving them.

These drugs dampen the pain signals coming from your brain during migraines.

Each works in a slightly different way, so if one doesn't help, your doctor may prescribe another.

Using a triptan along with an NSAID may work better than taking just a triptan.

Side effects from these drugs include tingling, flushing, a tightness in your chest, and feeling sleepy. If you're at risk for a stroke or heart attack, or have migraines with aura, triptans may not be safe for you to take.

Ditans and gepants are new treatments for acute migraines that can be used if the existing treatments are not helping or are not safe because of different health issues. Lasmiditan (Reyvow) is a ditan which is now available to treat migraine pain. Rimegepant (Nurtec) and ubrogepant (Ubrelvy) are CGRP antagonists or gepants that are approved to treat migraines once they have started. Zavegepant (Zavzpret) is a CGRP antagonist in the form of a nasal spray that may give fast relief from symptoms.

These drugs, which are based on a fungus that infects grains and grasses, work in much the same way as triptans. Ergot medicines come in different forms such as pills, shots, and nasal spray.

If you often have nausea during migraines, taking an ergot may make it worse. Your doctor can prescribe an anti-nausea drug, too, to prevent this.

Start your treatment at the first sign of a migraine attack to give it the best chance of working.

When you use any of these medicines more than twice a week, it can lead to a condition called "rebound headaches." Instead of helping to relieve your migraines, these drugs can cause you to have more.