Drugs for migraine headaches can relieve the pain and symptoms of a migraine attack and help prevent further migraine attacks.
Migraines can be treated with two types of drugs: abortive and preventive.
Abortive: The goal of abortive treatment is to stop a migraine once it starts. Abortive medications stop a migraine when you feel one coming or once it has begun. Abortive medications can be taken by self-injection, mouth, skin patch, or nasal spray. These forms of medication are especially useful for people who have nausea or vomiting related to their migraine, and they work quickly.
Abortive treatments include the triptans, which specifically target serotonin. They are all very similar in their action and chemical structure. The triptans are used only to treat headache and do not relieve pain from back problems, arthritis, menstruation, or other conditions. People with certain medical conditions should not take these medications.
The following drugs are also used for treatment:
- Acetaminophen -isometheptene-dichloralphenazone (Midrin)
- Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray)
- Ergotamine tartrate (Cafergot)
- Over- the-counter medications such as Advil Migraine (containing ibuprofen), Excedrin Migraine (containing aspirin, acetaminophen, caffeine), and Motrin Migraine Pain (containing ibuprofen)
The following drugs are sometimes used for nausea related to migraine headaches, in addition to migraine treatment:
- Metoclopramide (Reglan)
- Prochlorperazine ( Compro,)
- Chlorpromazine (Thorazine)
- Droperidol (Inapsine)
Some drugs are used for headache pain, but are not specific for migraines. These include analgesics, narcotics, and barbiturates. Since some of these can be habit forming, they are less desirable than specific headache drugs listed above. These drugs should be used primarily as a "backup" for the occasions when a specific drug does not work.
Preventive: This type of treatment is considered if migraines occur frequently, typically more than one migraine per week, or if migraine symptoms are severe. The goal is to lessen the frequency and severity of the migraine attacks. Medication to prevent a migraine can be taken daily. Preventive treatment medications include the following:
- Medications used to treat high blood pressure: beta-blockers (propranolol, timolol, metoprolol), calcium channel blockers (verapamil)
- Antidepressants: amitriptyline, nortriptyline (Aventyl, Pamelor)
- Antiseizure medications: gabapentin (Neurontin), topiramate (Topamax), valproic acid (Depakote)
If you can't take medication or wish not to, a device might be worth considering. Cefaly is the first FDA-approved device for preventing migraines in people over age 18. The portable headband-like device gives electrical impulses on the skin at the forehead. This stimulates a nerve associated with migraine headaches. Cefaly is used once a day for 20 minutes, and when it's on you may feel a tingling or massaging sensation.