Treat Migraines With These Options

What is a migraine?

A migraine is a debilitating type of headache that can last from a few hours to a few days. At the outset of a migraine, overactive nerve cells send impulses to the blood vessels, which triggers the release of certain hormones, such as serotonin, prostaglandins and estrogen. The release of these hormones causes the blood vessels near the nerve endings to swell, resulting in a migraine. Once an individual has experienced a migraine, they tend to recur.

Medication treatment for migraines

Factors that determine the type of medicine used to treat migraines include severity, whether nausea or vomiting is present, other existing medical conditions, and how disabling the migraine is. The main two categories of migraine medication include the following:

• Pain-relieving (acute) medication. Taken during a migraine, pain-relieving medication can help eliminate or significantly reduce symptoms.
• Preventative medication. In order to prevent or lessen the frequency of migraines, preventative medication is often prescribed. These medications can also reduce pain from a migraine.

Over-the-counter medications

There are a variety of pain-relieving medications that can be taken during a migraine attack to reduce the pain. Use caution when taking these medications to avoid stomach issues. Common over-the-counter medications include the following:

• Ibuprofen
• Acetaminophen
• Naproxen
• Aspirin
• Indomethacin (suppository-based medication)

Ergots

Certain medication may be prescribed for migraines that last longer than 48 hours. Ergots are more effective than over-the-counter pain relievers, but less effective than triptans, and include the following:

• Ergotamine
• Dihydroergotamine

Triptans

Triptans are prescription medications or injections that constrict blood vessels and block pain messengers. They include the following:

• Naratriptan
• Sumatriptan
• Rizatriptan
• Almotriptan
• Frovatriptan
• Zolmitriptan
• Eletriptan

Calcitonin gene-related peptide (CGRP)

Calcitonin gene-related peptide (CGRP) blocking medication is the newest treatment available to prevent and treat chronic migraines. The anti-CGRP monoclonal antibodies work by blocking the neurons to which CGRP attaches. Monoclonal antibodies adhere to the CGRP receptor on the neuron to prevent the CRGP from attaching to the nerve. Ubrogepant is the first CGRP receptor antagonist approved to treat an active migraine. Others include the following:

• Galcanezumab
• Erenumab
• Fremanuzumab

Anti-nausea medications

A combination of anti-nausea medication and other pain relievers may be effective at treating pain and nausea that can result from migraines. They include the following:

• Chlorpromazine
• Metoclopramide
• Prochlorperazine

Opioid medications

Opioid medications may be prescribed if migraines are severe. This is especially true if an individual cannot take triptans or ergots, or if they are ineffective. Examples of opioids include the following:

• Codeine
• Oxycodone
• Hydromorphone

Glucocorticoids

Used sparingly and with other pain relievers, glucocorticoids are an effective way to combat migraine pain. They may include the following:

• Prednisone
• Dexamethasone
• Hydrocortisone
• Fluticasone

Ditans

A new class of drugs called “ditans” works similarly to triptans; however, they do not have the same restrictions. This medication can be taken during an aura to reduce pain, nausea, and sensitivity to light and sound. Lasmiditan is the first medication in this class of drugs.