Medications

Two kinds of medicines are used to treat migraines:

• Medicines to stop a migraine. These are sometimes called abortive medicines. These may be over-the-counter or prescription medicines. If you take the medicine at the first sign you're getting a migraine, you may stop the headache before it starts.
• Medicines to prevent migraines. These drugs are often called preventive medicines. You get them with a prescription. You take these every day or whenever your doctor tells you to.

Finding the right mix of medicines for you may take some time. So work closely with your doctor to try different medicines and doses.

In most cases, your doctor will first prescribe a drug that causes the fewest side effects. Drugs may be prescribed based on your type of migraine.

Medication Choices

Medicines to stop a migraine

If your migraines are mild to moderate, you may need only an over-the-counter drug to stop the pain. Most doctors recommend that you try these drugs first, because they may have fewer side effects than prescription drugs. If over-the-counter drugs don't stop your headaches, your doctor may prescribe other medicine.

Your doctor may suggest that you take a mix of medicines to stop a headache. For example, you may take acetaminophen or naproxen along with a prescription medicine, such as a triptan.

Drugs used to stop a migraine include:

• Over-the-counter medicines like acetaminophen (Tylenol, for example) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. Brand names for NSAIDs include Bayer, Advil, and Aleve. Some over-the-counter medicines (for example, Excedrin) combine acetaminophen, aspirin, and caffeine.
• Triptans (serotonin receptor agonists), such as sumatriptan (Imitrex) and zolmitriptan (Zomig).
• Ergotamine derivatives, such as Cafergot.
• Midrin, which is a mix of the drugs isometheptene, acetaminophen, and dichloralphenazone.

Medicines to prevent migraines

Drugs used to prevent migraines include:

• Beta-blockers, such as propranolol.
• Anticonvulsants, such as topiramate.
• Antidepressants, such as amitriptyline.
• Calcium channel blockers, such as verapamil.
• Botulinum toxin, such as Botox.

You may want to try medicine to prevent a headache if:

• You are using medicines to stop headaches more than twice a week.
• Medicines to stop migraines aren't working well for you.
• You have two or more headaches a month that keep you from doing your daily activities.
• You have uncommon migraine symptoms, such as a long period with aura or numbness during your headache.

For more information, see:

Headaches: Should I Take Medicine to Prevent Migraines?

What to Think About

Rebound headaches

Taking medicine too often to stop a migraine can cause more headaches. These rebound headaches are different from migraine headaches. They usually start after pain medicine wears off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the drug.

Talk to your doctor if you are taking headache medicine more than 2 days a week. Take your medicine as prescribed by your doctor.

Other things to think about

• Depression and migraines. Many people who have migraines also have depression. Taking prescription medicine for both problems is common.
  • Make sure your doctor knows about all the medicines that you take. In very rare cases, a serious condition called serotonin syndrome may happen when a person takes a triptan for migraines and an SSRI (selective serotonin reuptake inhibitor) or SNRI (selective serotonin/norepinephrine reuptake inhibitor) for depression. But most people have no problems when they take these medicines together. Talk to your doctor if you are concerned about this problem.
• Antinausea medicine. If you have nausea or vomiting during migraine attacks, your doctor also may prescribe medicine to help with these symptoms.