Acute Migraine Treatments

Acute migraine treatments are used to stop a migraine attack or get relief from symptoms. If the treatment is a drug, it may also be called an "abortive" or “rescue” drug. Acute treatments typically are not used ahead of time or to prevent a migraine attack. Rather, they are most effective taken at the start of a migraine.^1,2

What are acute migraine treatments?

Unlike preventive drugs, acute treatments are taken at the first sign of a migraine. Preventive drugs are taken on a regular schedule. They reduce the number and severity of future migraine attacks. Acute migraine treatments manage the headache itself and possibly associated symptoms of the migraine you are experiencing.^1,2

The specific way an acute migraine treatment works depends on the drug. Some acute treatments are designed specifically for migraine. Others are used for many types of pain management.^2,3

Acute treatments work best when you use them at the first sign of a migraine. There are many different types of acute treatments. Some are specific for migraine. Others treat pain or nausea. The best choice for you depends on:^1-3

• How severe your migraine is
• What drugs help
• Which side effects bother you
• How much the treatment costs
• Your other health conditions

Examples of acute migraine treatments

Drugs that are specific for treating migraine acutely include:^1,2

• Triptans
• Ergotamine or dihydroergotamine (DHE)
• Gepants
• Ditans
• Combination of nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans

These drugs are more commonly used for moderate and severe migraine attacks.^1,2

Drugs that treat more general symptoms include:^1,2

• Combination analgesics with acetaminophen, aspirin, and caffeine
• NSAIDs, including aspirin, celecoxib oral solution, diclofenac, ibuprofen, naproxen
• Antinausea drugs, including chlorpromazine, droperidol, metoclopramide, prochlorperazine, promethazine

For some people, migraine symptoms include severe nausea or vomiting. In this case, drugs that are taken by mouth (orally) may not stay down long enough to work. Better forms for taking these drugs include nasal sprays or injections (shots). Or you could use a drug to relieve nausea and vomiting along with your migraine treatment.^1,2

There are also non-drug options for acute treatment of migraine. Remote electrical neuromodulation is a migraine device that simulates nerves in the upper arm. Activating these nerves changes how the brain processes pain and reduces migraine pain.¹

What are the possible side effects?

Side effects can vary depending on the specific treatment you are taking. For example:^1-3

• Triptans may cause tingling, feeling tired, flushing, and throat or chest tightness. Triptans are also more likely to contribute to “medication overuse headache.” This happens when using a drug starts to cause headaches instead of relieving them, a rebound effect.
• Gepants may cause nausea, feeling tired, and dry mouth.
• Lasmiditan, ergotamine, and dihydroergotamine may cause dizziness, feeling tired, nausea, and weakness.

These are not all the possible side effects of acute migraine treatments. Talk to your doctor about what to expect when taking acute migraine treatments. You also should call your healthcare provider if you have any changes that concern you when taking acute migraine treatments.

Other things to know

The best acute migraine treatment for you depends on the severity of your migraine or how migraine is impacting your overall quality of life. For mild cases, over-the-counter treatments such as acetaminophen or NSAIDs may be enough. For more severe cases, you may need to try other prescriptions or a combination of treatments. There are also non-medication options available that can be considered an acute migraine treatment such as lifestyle considerations or neuromodulation devices.^1,2

Acute migraine treatment should relieve your symptoms and help you feel better. If your treatment is not helping you, speak with your healthcare provider. If you use an acute treatment more than 2 to 3 times per week, your healthcare provider may recommend a different treatment or preventive strategies.^1-3

Before beginning treatment for migraine, tell your healthcare provider about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.