Migraine Treatments

By Dr Ananya Mandal, MD

Currently, there is no known cure for migraine and treatment is aimed at preventing headache onset and relieving symptoms when they do occur.

The symptoms of migraine do not always respond to treatment in the same way and it is important that migraine sufferers take time to find out which treatment or combination of treatments work for them. In addition, the migraine attacks are often triggered by particular factors, which a sufferer needs to carefully identify if they are to be avoided. People who cannot manage their migraine symptoms using over-the-counter medications should consult their doctor.

Treatment outline

Some examples of the types of treatments that may be used for cases of migraine include:

Pain relievers

Over-the-counter pain relievers such as paracetamol, ibuprofen and aspirin can help ease the pain caused by migraine and are usually the first approach to treatment in migraine. However, over-use of pain killers can also increase the incidence of migraine attacks as well as making them more severe. Pain relief is more effective at relieving symptoms if taken when early warning signs start, so the drug has time to dissolve in the bloodstream and act on the body before the severe headache begins. Pain relief taken once the headache has already become severe is often ineffective. Soluble painkillers work more rapidly than insoluble forms do.

Anti-inflammatory medications

Anti-inflammatories such as ibuprofen can provide effective relief from the symptoms of migraine. Ibuprofen can be bought over the counter while other anti-inflammatories such as diclofenac, naproxen and tolfenamic acid need to be prescribed by a doctor.

Triptans

Triptans may be recommended in cases where migraine symptoms are not relieved by painkillers. Some triptans such as sumatriptan are available over the counter, while others require a prescription. These drugs work by constricting blood vessels, therefore counteracting the widening of vessels that is thought to contribute to the process of migraine. Triptans are available in the form of pills and nasal spray.

Antiemetics or anti-sickness medications

Antiemetics can be effective against migraine, even in the absence of nausea and these drugs can be taken alongside painkillers. If the vomiting is severe, these medications can also be taken as suppositories (dissolvable pills inserted into the anus or the back passage for easy absorption).

Transcranial magnetic stimulation (TMS)

TMS is a treatment procedure that has recently been approved for the treatment and prevention of migraines. A small magnetic device is held against the head and delivers magnetic pulses through the skin. Research has shown that this can reduce the severity of migraines. TMS can also be used in combination with the medications described above.

Reviewed by Sally Robertson, BSc

Sources

  1. http://www.nhs.uk/conditions/migraine/Pages/Introduction.aspx
  2. http://www.nice.org.uk/nicemedia/live/13901/60853/60853.pdf
  3. http://www.acponline.org/patients_families/pdfs/health/migraine.pdf
  4. http://www.pfizer.ca/local/files/en/yourhealth/Migraine.pdf
  5. http://www.ghc.org/all-sites/guidelines/headache.pdf
  6. http://www.americanheadachesociety.org/assets/1/7/NAP_for_Web_-_Acute_Treatment_of_Migraine.pdf
  7. http://www.americanheadachesociety.org/assets/1/7/What_is_Migraine_February_2008.pdf
  8. http://uhs.berkeley.edu/home/healthtopics/pdf/triggers.pdf
  9. http://www.womenshealth.gov/publications/our-publications/fact-sheet/migraine.pdf

Further Reading

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