Acute Migraine Treatment
Reviewed by: HU Medical Review Board | Reviewed March 2022 | Last updated: March 2023
Acute treatments help when you want to stop a migraine attack and get relief from symptoms.
Acute treatments may also be called “abortive” or “rescue” medications. These terms are often used interchangeably, but some people have more specific definitions for each word. For example, they may say that an “abortive” medication is the first drug you take when you feel a migraine starting. A “rescue” medication might be the medication you take if your first treatment does not work.1 If you are not sure how a person is using a term, just ask! It is not a silly question.
Should I use an acute or preventive treatment?
Understanding the purpose of a medication is important for finding the right treatment strategy for your migraines. People who have infrequent migraines (fewer than 4 per month) may treat them with acute medications alone. People with frequent or severe migraines may take an ongoing preventive medication. Preventives reduce the number and severity of migraines. If you take a preventive, you can also take an acute medication when a migraine starts.1
How do I know which acute medication to take?
Acute medications work best when taken at the first sign that a migraine is coming.1 A wide range of medications are used. Some are specific for migraine. Others are general medications for pain or nausea. The best choice for you depends on how severe your migraine is, what medications provide relief, which side effects bother you, how much the medication costs, and other health conditions you may have.2
Keeping a migraine journal can help the doctor determine the severity of migraine attacks and give the migraine specialist a better understanding of which medications may work best.
How do nausea or vomiting affect my medication?
For people whose migraine symptoms include severe nausea or vomiting, oral medications aren’t recommended because they may not stay down long enough to work. If symptoms include severe nausea or vomiting, oral melts may be used, or non-oral medications like nasal sprays or injectables may be tried. Using anti-emetics, drugs which may ease nausea and vomiting, in conjunction with migraine medications may also be an option.3
What are the types of acute medications?
Migraine-specific acute medications, typically used for moderate-to-severe migraine, include:
Non-specific acute medications, which may be helpful for mild-to-moderate migraine, include:
- Acetaminophen and NSAIDs
- Narcotic, or opioid, analgesics
- Anti-nausea medications
Non-drug options include non-invasive devices.
When you've taken abortive medications do they quickly relieve their symptoms?
What if my acute migraine medications aren't working?
Acute migraine treatment should relieve your symptoms and help you to function again.1 If your acute medications are not helping you achieve these goals, speak with your healthcare provider. If you need acute medications more than 2 to 3 times per week for migraine, it may be time for a new treatment strategy.
What should I talk to my doctor about?
You should not begin a medication or supplement without checking with your healthcare provider and letting them know of any other prescriptions, OTCs, and herbals you are taking to ensure there are no interactions. Patients should talk to their doctor about what to expect for potential side effects from acute treatment.