Migraine is a complex and often debilitating disorder. There are different types of migraine, and several treatment options. Migraine treatment approaches can be classified as acute treatments, which aim to reverse or stop the migraine symptoms, and preventive treatments, which aim to reduce the frequency and severity of migraines. Many people with migraine need both types of treatment. Another treatment strategy is to identify and avoid personal triggers.1
To help figure out the best treatment approach, it’s helpful to start with a migraine journal. Keeping an accurate, complete diary of every migraine attack and all of your symptoms will help your migraine specialist make a correct migraine diagnosis. The record of your pattern of pain will also assist the doctor in determining which treatment might work best for your situation.
The goal of migraine treatment
The U.S. Headache Consortium lists the following goals of long-term migraine treatment:
- Reduce attack frequency and severity
- Reduce disability
- Improve quality of life
- Prevent headache
- Avoid headache medication escalation
- Educate and enable patients to manage their disease2
In addition, the U.S. Headache Consortium has established the following goals for successful treatment of acute migraine attacks:
- Treat attacks rapidly and consistently without recurrence
- Restore the individual’s ability to function
- Minimize the use of back-up and rescue medications
- Optimize self-care
- Be cost-effective
- Minimize side effects2
Types of migraine treatments
Migraine treatments can be divided into various classifications: acute or preventive, as well as prescription or over-the-counter (OTC). Acute medications are those used when a migraine attack is currently happening. They are also known as abortive medications. Preventive medications are used on an ongoing basis, even when an attack is not occurring, in the hope that they will prevent or reduce attacks. Preventive medications are also called prophylactic medications.
Prescription migraine treatments
Examples of preventive or prophylactic prescription medications include:
- Calcitonin-gene-related peptide (CGRP) inhibitors
- Beta blockers
- Calcium channel blockers
- Neuronal stabilizing agents or anticonvulsants
OTC medications for acute symptoms relief include:
- Excedrin for migraine
- Ibuprofen, which is sold under the brand names Advil and Motrin
- Naproxen, sold under the brand name Aleve
- Acetaminophen, sold under the brand name Tylenol
In addition to medications, the U.S. Food and Drug Administration (FDA) has approved two nerve stimulators that may be used in certain people with migraines who have not gotten relief from other methods.
- The Cerena Transcranial Magnetic Stimulator is a device that is approved for people 18 years of age and older who have migraines with aura. It is held to the back of the head and delivers a pulse of magnetic energy.
- A vagus nerve stimulator has also been approved for use in adults with migraines, as well as episodic cluster headaches. The hand-held device is placed over the vagus nerve in the neck where it releases a mild electrical stimulation to reduce pain.1
Complementary and Alternative Medicine
Some people with migraines also use complementary and alternative medicine approaches to get relief from their migraine symptoms. Complementary and alternative medicine includes any medicinal products or practices that are not part of mainstream medicine given by medical doctors and allied health professionals, such as nurses or physical therapists. Alternative medicine is also defined by its use as an alternate to traditional medical care. Complementary medicine is used in combination with traditional medicine. These types of treatments include:
As always, the best source for advice on treating your migraine is your own migraine specialist. These medication descriptions are provided only for informational purposes. You should begin no medication regimen without first checking with your physician.
- Chawla J. Migraine headache treatment & management. Medscape. Available at https://emedicine.medscape.com/article/1142556-treatment. Accessed 4/30/18.
- Aukerman G, Knutson D, Miser W. Management of the acute migraine headache. Am Fam Physician. 2002 Dec 1;66(11):2123-2131.