Acute Migraine Treatment

Migraine medications for acute symptom relief

When head pain and other migraine symptoms start, acute treatment medications, also known as abortive or rescue medications, are taken to stop the migraine attack and provide immediate symptom relief. The best time to take these medications is at the very first sign that a migraine is coming. These treatments usually work best in the early stages of a migraine attack when the symptoms haven’t grown to full force.

The goal of acute treatment for migraine

When migraine symptoms begin, acute treatment is designed to quickly relieve the pain and migraine symptoms. Ideally, these medications should consistently ease symptoms and keep them away for at least 24 hours.

The U.S. Headache Consortium has established the following goals for successful acute treatment of migraine attacks:

  • Treats attacks rapidly and consistently without recurrence
  • Restores the individual’s ability to function
  • Minimizes the use of backup and rescue medication
  • Optimizes self-care
  • Is cost effective for overall management
  • Has minimal or no side effects1

Choosing the right migraine treatment

The choice of acute or abortive medications is based on several factors, including the severity of the migraine attacks, whether the individual has nausea and vomiting with migraine, other health conditions the person may have, and how well the medication works for the individual. Side effects of the treatment are also a concern and will help determine which medication is best.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.

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, non-oral medications such as nasal sprays or oral melts may be used. Using anti-emetics, drugs which may ease nausea and vomiting, in conjunction with migraine medications may also be an option.2

Doctors also recommend against using many acute treatment medications more than twice a week. More frequent use may lead to medication overuse, or rebound, headache. If migraine attacks are recurring more frequently, additional medication to prevent migraine may be needed.

Types of acute migraine medications

Many different types of medications are used for acute migraine treatment, some of which include:

The U.S. Headache Consortium recommends:

  • For mild to moderate migraine attacks, using the options of NSAIDs, combination pain relievers containing caffeine, or isometheptene combinations
  • For moderate to severe migraine attacks or milder migraines that have not responded to other medications, using the options of migraine-specific drugs (like triptans or DHE), combination pain relievers containing caffeine, or other drugs like ergotamines
  • For migraines with nausea and vomiting, using a non-oral route of administration
  • For severe migraine attacks that do not respond to other treatment, using a rescue medication1

When migraine attacks are identified early and acute medications are given, most can be stopped with these medications.1

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Written by: Otesa Miles and Emily Downward | Last review date: May 2018
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