Treatment Options for Acute Migraine

One out of every six American adults is affected by migraine disease. Between the intense hours-long headaches, nausea or vomiting, and sensitivity to light and sound, there’s no doubt that migraine attacks can be debilitating. However, the right treatment can improve migraine symptoms or even stop them in their tracks. If you’re searching for migraine relief as symptoms start to develop, here’s what you should know.

What medications are used for treating acute migraine episodes?

Acute migraine treatment works to combat migraine symptoms once they appear, as opposed to migraine prevention medication, which works to stop them from occurring. Both over-the-counter and prescription medications are used to treat acute migraine attacks, including:

Pain relievers: Common pain medications may be effective for treating mild to moderate migraine episodes. Examples include ibuprofen (Motrin, Advil), naproxen sodium (Aleve), and acetaminophen (Tylenol).
Triptans: These prescription medications come in the form of pills, nasal sprays, and injections. They reduce inflammation and constrict blood vessels, which helps stop moderate to severe migraine episodes. Examples are sumatriptan (Imitrex) and rizatriptan (Maxalt).
Ergots: Dihydroergotamine and ergotamine work similarly to triptans by constricting certain blood vessels in the head. They’re prescribed in many formulations including pills, suppositories, injections, and nasal sprays. Some are combined with caffeine.
Calcitonin gene-related peptide (CGRP) antagonists: Ubrogepant (Ubrelvy) and rimegepant (Nurtec) are newer oral medications that have been proven to be effective for treating pain and other migraine symptoms. They block a protein in your body called CGRP that plays a role in migraine development.
Ditans: Lasmiditan (Reyvow) is another relatively new oral medication for migraine. It doesn’t cause blood vessel constriction so it can be prescribed to individuals who can’t take triptans or ergots due to certain cardiovascular conditions.

Your doctor will consider your migraine severity and frequency, your migraine treatment history, your treatment preferences, and any co-existing health conditions when determining which medication is best for you.

What are some tips for finding migraine relief?
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When you feel a migraine episode coming on, it’s important to have a plan of action so you can get relief as soon as possible. To boost your chances of alleviating migraine pain:

Learn to recognize early symptoms: Some people experience an aura – sensations such as seeing flashes or halos of light –which precedes the actual headache.
Act quickly: Take your migraine medication as soon as you feel symptoms coming on. Many medications are most effective early in the course of your migraine attack.
Take medication as directed: Make sure you are taking the correct dose of migraine medication. Re-dose as ordered.
Avoid bright lights and sounds: Find a dark and quiet room to rest in with your eyes closed.
Use cold therapy: Apply a cool cloth or ice pack to your forehead.
Hydrate: Drink plenty of fluids. Caffeine-containing drinks may help.

If you find that your migraine treatment is working less than half of the time or you’re still unable to function after a few hours, let your doctor know. You may respond better to a different medication.

Similarly, if you are reaching for your migraine medication more than nine times a month, be sure to talk to your doctor. In some cases, rebound headaches (also called medication overuse headaches) can occur when the pain-relieving component wears off. Frequent use of acute migration medication may also be a sign you’d benefit from the addition of migraine prevention medication to your treatment regimen.

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