How to Control Migraine Attack Migraine Prevention Medications

Common Medical Interventions for Migraines

When you are diagnosed as a migraineur, your doctor will typically prescribe medications based on the severity of your symptoms as well as any other health conditions you have. Over-the-counter medicines will rarely provide relief.

Of course, there are always risks involved in relying on medication. Furthermore, taking any of these medicines for more than 10 days out of a 30-day period, for longer than 3 months, can cause more headaches due to medication overuse.

Medications prescribed to migraine sufferers fall into one of two categories. Pain-relieving medications are taken during attacks—ideally during the prodrome or aura stage—and are designed to stop symptoms from progressing further. Preventive medications are taken regularly, usually on a daily basis, to reduce the severity and/or frequency of migraine episodes.

Pain-Relieving Medications:

Pain-relieving medications include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. The most common antimigraine analgesic is triptan, with nearly half of those prescriptions being for sumatriptan (Imitrex). Triptans work by promoting the constriction of blood vessels in the brain while simultaneously blocking pain pathways. This counteracts the blood vessel dilation that is thought to be a contributing factor to the development of migraines.

Ergots. Ergots, such as Migranal and Cafergot, are combination drugs containing ergotamine and caffeine. (While caffeine itself is a common trigger, it can also be preventive when used strategically.) They are sometimes prescribed as they prevent the dilation of blood vessels, which causes migraines, and they are most effective in those whose pain usually lasts longer than 48 hours. Ergots have been shown to be less effective than triptans in head-to-head trials and are typically only effective if taken in the early stages of a migraine. Ergots often worsen the nausea and vomiting related to migraines and are dangerous due to the high risk of poisoning, which can lead to gangrene, vision problems, unconsciousness, and even death.

Opioid Medications. For those who cannot take triptans or ergots, opioid medications containing narcotics—usually codeine—are sometimes prescribed. Opioid medications are highly addictive and can cause drowsiness, constipation, sleep apnea, and heart and lung problems. They are generally only used as a last resort.

Preventive Medications:

Preventive medications are usually prescribed to those who suffer from two or more migraines per month, which do not generally respond to pain-relieving medication, and to those who experience attacks lasting more than 12 hours. These drugs not only help prevent the onset of migraines but also make the body more responsive to pain-relieving medications.

Doctors may prescribe a daily medication or something to be taken only when a predictable trigger, such as menstruation, is approaching. These preventive drugs—including antidepressants, antiseizure drugs, and cardiovascular drugs—are potentially more dangerous than pain-relieving medications as they can cause a number of serious side effects.

Antidepressants. Certain antidepressants can help prevent migraines by altering the level of serotonin and other chemicals within the brain, but they also commonly cause mouth dryness, constipation, and weight gain.

Antiseizure Drugs. Antiseizure drugs are also commonly prescribed to migraine sufferers, yet they can cause nausea, diarrhea, tremor, weight gain, hair loss, and dizziness.

Botox. For those who do not tolerate traditional migraine medication well, there is one alternative for chronic sufferers. Botox, or onabotulinum toxin A, is well known for smoothing out wrinkles, but it is also linked to treating chronic migraines in adults. In 2010, the US Food and Drug Administration approved the drug as a treatment option for those who suffer migraines for 15 days or more each month. Botox is not thought to grant any benefits to nonchronic sufferers.

When used as a treatment option, multiple Botox injections are made into the forehead and neck every 12 weeks. These injections help prevent or dull future symptoms associated with the headache portion of the migraine episode. It can take up to 14 days to witness any kind of improvement, and some people require multiple treatments before they experience any relief.

The major risks of Botox include neck pain and further headaches and, in rare cases, muscle weakness and vision problems.

Cardiovascular Drugs. Cardiovascular drugs, like beta-blockers and calcium channel blockers, can be very effective in preventing migraines and relieving symptoms during attacks; however, they often cause fatigue, digestive problems, dizziness, and shortness of breath.