How Migraines Are Treated

What are your options for symptom relief?

There are a number of effective migraine headache treatments. These treatments are often referred to as abortive treatments because they are intended to stop a migraine once symptoms have already started. Abortive treatments include over-the-counter and prescription medications, but lifestyle factors and home remedies can have a big impact as well—especially when used along with migraine medication.

Abortive migraine treatment is different than preventative or prophylactic treatments, which are used on a regular schedule to prevent migraines from occurring in the first place. In some instances, medical treatments such as intravenous (IV) injections are needed to stop a migraine.

Migraines cause a variety of symptoms, including head and neck pain, severe exhaustion, visual effects, trouble concentrating, and numbness of the hands or fingers. Treatment of a migraine episode often relieves the pain, but you may still continue to experience many of the other migraine symptoms even after the pain subsides.

Treatment of migraines
Illustration by Brianna Gilmartin, Verywell 

Home Remedies and Lifestyle

When you have a migraine headache, home remedies can prevent it from getting worse, reduce the symptoms, and may even completely alleviate it. The most effective home remedies for migraine include a variety of options. 

Use Cold Packs

When you have head pain, neck pain, shoulder pain, or facial pain with your migraine, placing a cold pack on the sensitive area can alleviate the pain and may eliminate the symptoms altogether. 

Peace of Mind

Sometimes, resting and taking your mind off complicated or stressful issues can help alleviate your migraine symptoms. This is important for overall mental health and can aid in your migraine relief as well.

Get Enough Sleep

If you have time to sleep, this can relieve your migraine. Keep in mind, however, that migraines can make it difficult for you to fall asleep if the pain or other symptoms are distracting or overwhelming. Sleep plays a role in the prevention of migraines as well.

Consume Caffeine

The link between caffeine and migraines can be complicated. If you don’t regularly drink caffeinated beverages, just one serving can reduce your migraine symptoms or may even completely stop your migraine. Some people experience severe migraines after consuming caffeine, so this solution isn’t for everyone.

However, keep in mind that caffeine withdrawal can also induce a migraine, so overusing this method can backfire. Being aware of your caffeine intake is also crucial for migraine prevention.

Get Fresh Air

Sometimes, getting outside can help alleviate a migraine, especially if you are enclosed in a space without good circulation or exposed to strong, bothersome odors. Excessively cold weather or humidity can trigger or exacerbate migraines, however. 

Enjoy Yourself

Migraines are true neurological events. But doing something enjoyable can distract you from the symptoms, especially if you are dealing with a mild to moderate migraine. Try finding a calming activity that you find enjoyable to help relieve the symptoms of your migraines.

Over-the-Counter (OTC) Therapies 

Some non-prescription medications can help lessen the symptoms of a migraine. These tend to be more effective when taken right at the start of a migraine or even before it starts (if you notice a prodrome before your migraine). These non-prescription medications can help reduce your symptoms even if you take them after your symptoms have started. 

  • Non-steroidal anti-inflammatories (NSAIDS). Medications such as aspirin, ibuprofen, and naproxen are all pain relievers and anti-inflammatories that can help take the edge off migraine symptoms, eliminate a migraine completely, or aid in the prevention of a migraine altogether. Be sure to use as directed, as these medications can cause stomach upset and may increase your risk of bleeding, especially when taken frequently or at high doses. 
  • Acetaminophen. Acetaminophen is a pain reliever that is not an NSAID and is not associated with the stomach upset and bleeding effects that can occur with NSAIDs.
  • Excedrin Migraine. This medication contains a combination of acetaminophen, aspirin, and caffeine. 

Be sure to discuss your migraine treatment with your doctor, as many of the medications can produce side effects. Aim to take the lowest dose of over-the-counter medications that can relieve your migraine episodes, because this strategy can help prevent rebound migraines and averts the need to constantly increase your medication dose.

Prescriptions

Prescription medications can be used during a migraine attack. A number of medications are specifically indicated for the treatment of migraine episodes, and some treatments that are indicated for other conditions are often used for the treatment of migraine episodes as well. 

If you have recurrent migraines, your doctor might give you a prescription for one several different medications commonly prescribed for treating migraines.

Migraine Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Man

Triptans

There are many different triptans, and this category of medicines is approved for the treatment of acute migraine. Triptans include Imitrex (sumatriptan), Relpax (eletriptan), Zomig (zolmitriptan), Amerge (naratriptan), Maxalt (rizatriptan), Axert (almotriptan), and Frova (frovatriptan).

These medications are serotonin agonists, which means that they work directly on serotonin receptors to stop migraines. They also induce vasoconstriction (narrowing of the blood vessels), which may be related to their therapeutic effect.

Triptans are powerful medications and can increase the risk of heart attack and stroke, so they are not recommended for use if you have risk factors for these conditions.

Fioricet and Fiorinal

Fioricet is a combination of acetaminophen, caffeine, and butalbital, while Fiorinal is a combination of aspirin, caffeine, and butalbital, which can also be combined with codeine (a narcotic). Butalbital is a barbiturate, which means that it acts like a depressant and can make you sleepy. It is also addictive and can cause side effects such as shaking, confusion, and tremors. 

The American Academy of Neurology strongly recommends against using butalbital for migraines, except as a last resort. While Fioricet and Fiorinal have been used for migraines in the past, they should no longer be used because the risks outweigh the potential (modest) benefit.

Ergots

Dihydroergotamine and ergotamine (Cafergot) are potent vasoconstrictors that are effective in alleviating migraine symptoms. They can cause serious side effects, however, and are not recommended if you have blood vessel disease, kidney disease, or heart disease.

Steroids

Oral steroids have been used to both prevent migraines and reduce symptoms of acute migraines. Many people experience relief of pain and other migraine symptoms with this treatment. Speak with your doctor to find out if this is a viable treatment for your migraines.

Opioids

Opioids, also referred to as narcotics, have been used in some instances for the treatment of migraines. Opioids should not be used for migraines in anyone, except in exceptional circumstances, according to the American Academy of Neurology. Opioid medications, which include codeine, fentanyl, and hydrocodone, are not the most effective option for treating migraine symptoms, and they are highly addictive. 

Reglan (Metoclopramide)

An antiemetic used for treatment of nausea and gastroesophageal reflux, Reglan can be used for migraine relief. Because most migraine treatments are not safe during pregnancy, Reglan is often the preferred migraine therapy during pregnancy.

However, the medication is associated with a distressing side effect called focal dystonia, which causes a strong involuntary muscle contraction often described as “lockjaw."

Periactin (Cyproheptadine)

An antihistamine medication generally used for allergies, Periactin is often used to treat migraines in children. 

Lasmiditan

Like the triptans, lasmiditan is a serotonin receptor agonist. It works a little differently, however, by altering electrical activity in the brain, not by inducing vasoconstriction. This medication is still under investigation and has not been approved for use.

Keep in mind that migraines are known to cause nausea and vomiting. If you are unable to take oral medications, you might benefit by taking your migraine treatment by injection, nasal, or rectal route.

Migranal, sumatriptan, and zolmitriptan are all available in a formulation that can be inhaled, and sumatriptan is available in a formulation that can be administered rectally, as well as a formulation that is self-administered by subdural injection (right below the skin).

Surgeries and Specialist-Driven Procedures 

Surgical procedures and injections are generally considered preventative approaches to migraine therapy and are not typically used for the treatment of an acute attack. However, there are some techniques that can help in the treatment of acute migraine attacks that do not respond to oral medications.

Injections

In some cases, injection of an anesthetic, a muscle relaxant, or steroids can be used when a migraine is not responding to any other therapy, with inconsistent success rates. Intravenous infusions of ketamine or propofol, both powerful anesthetics sometimes used for surgical anesthesia, have been used for acute migraine treatment.

Spring TMS

A non-invasive device approved for migraine treatment, this magnetic stimulator this is placed at the back of the head to deliver a magnetic pulse, which can stop a migraine attack. (TMS stands for transcranial magnetic stimulation.) This is considered a safe treatment without risks or side effects.

Complementary and Alternative Medicines (CAM)

CAM approaches to migraine treatment can be very effective for some people. However, not everyone experiences relief with these options. They are considered safe, and if you experience migraines, it may be worth trying CAM treatments to see if they can work for you. 

Ginger

In terms of oral supplements, ginger is the only one that has been consistently proven effective in alleviating the symptoms of acute migraine. It can be consumed raw, as gum or candy, or in hot or cold tea.

Tiger Balm

As a topical treatment, Tiger Balm is more effective than placebo and equally as effective as medication in reducing tension headaches. It has also been used in migraine treatment with some success.

Lavender Oil

Lavender oil is the only aromatherapy that has been proven effective in the treatment of episodes of migraine. It is a safe option—inhalation of lavender oil can reduce the severity of a migraine and may eliminate the symptoms as well.

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