
Migraine headache is a type of headache that is often accompanied by a range of symptoms, including sensitivity to light and sound, nausea, and vomiting. Migraines can be extremely debilitating and can last for several hours or even days.
Migraines are more common in women than in men, and hormonal changes are thought to be a contributing factor. Many women report that their migraines are more frequent and more severe during certain times of the month, such as during menstruation.
There is no cure for migraines, but there are a number of treatments available that can help to reduce the frequency and severity of migraines. Treatment options may include medication, such as pain relievers, triptans, or preventive medications, as well as lifestyle changes, such as reducing stress, getting regular exercise, and avoiding triggers that can bring on migraines.
For women, hormonal treatments such as birth control pills or hormone replacement therapy may also be used to help manage migraines. It’s important to work closely with a healthcare provider to determine the best course of treatment for your individual needs and to ensure that you are managing your migraines effectively.
Migraines can be treated with two types of drugs: abortive and preventive.
Abortive medication for migraine
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 and ditans, 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.
Almotriptan (Axert)
Eletriptan (Relpax)
Frovatriptan (Frova)
Naratriptan (Amerge)
Rizatriptan (Maxalt)
Sumatriptan (Alsuma, Imitrex, Onzetra, Sumavel, Zembrace)
Zolmitriptan (Zomig)
The following drugs are also used for treatment:
OTC pain meds and combination pain meds including: Advil Migraine (containing ibuprofen), Excedrin Migraine (containing aspirin, acetaminophen, caffeine), isometheptene-dichloralphenazone-acetaminophen (Midrin), and Motrin Migraine Pain (containing ibuprofen)
Ergots including: Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray), Ergotamine tartrate (Cafergot)
CGRP antagonists: rimegepant (Nurtec ODT) : Preventive medication for migraine
This type 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 (Elavil), nortriptyline (Aventyl, Pamelor)
Antiseizure medications: gabapentin (Neurontin), topiramate (Topamax), valproic acid (Depakote)
CGRP inhibitors used to block the calcitonin gene-related peptide: atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality), rimegepant (Nurtec)
Botox
×××Nausea drugs for migraine
Many people who have migraines often have nausea and vomiting along with head pain. Those symptoms usually get better when you treat the migraine. But sometimes, the nausea and vomiting are bad enough to keep a person from taking their migraine medications. In these cases, a nausea drug can ease your symptoms so you can get the treatment you need.
×××Most nausea medicines come in pill form, but if the problem is severe, you can take them as a rectal suppository.
××× If you can’t take medication or wish not to, a device might be worth considering. These include:
Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.
Noninvasive vagus nerve stimulator (nVS). GammaCore is a hand-held portable device placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
Nerivio, a wireless remote electrical neuromodulation device that is self-applied to the upper arm and should be used in the home environment at the onset of migraine headache.
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