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Medications Many Options Available

Migraine treatment is aimed at relieving symptoms and preventing additional attacks. Quick steps to ease symptoms may include napping or resting with eyes closed in a quiet, darkened room; placing a cool cloth or ice pack on the forehead, and drinking lots of fluid, particularly if the migraine is accompanied by vomiting. Small amounts of caffeine may help relieve symptoms during a migraine's early stages.

Drug therapy for migraine is divided into acute and preventive treatment. Acute or "abortive" medications are taken as soon as symptoms occur to relieve pain and restore function. Headache drug use should be monitored by a physician, since some drugs may cause side effects.

Acute treatment for migraine may include any of the following drugs:

  • Triptan drugs increase levels of the neurotransmitter serotonin in the brain. Serotonin causes blood vessels to constrict and lowers the pain threshold. Triptans--the preferred treatment for migraine--ease moderate to severe migraine pain and are available as tablets, nasal sprays, and injections.
  • Ergot derivative drugs bind to serotonin receptors on nerve cells and decrease the transmission of pain messages along nerve fibers. They are most effective during the early stages of migraine and are available as nasal sprays and injections.
  • Non-prescription analgesics or over-the-counter drugs such as ibuprofen, aspirin, or acetaminophen can ease the pain of less severe migraine headache.
  • Combination analgesics involve a mix of drugs such as acetaminophen plus caffeine and/or a narcotic for migraine that may be resistant to simple analgesics.
  • Nonsteroidal anti-inflammatory drugs can reduce inflammation and alleviate pain.
  • Nausea relief drugs can ease queasiness brought on by various types of headache.
  • Narcotics are prescribed briefly to relieve pain. These drugs should not be used to treat chronic headaches.

Taking headache relief drugs more than three times a week may lead to medication overuse headache (previously called rebound headache), in which the initial headache is relieved temporarily but reappears as the drug wears off. Taking more of the drug to treat the new headache leads to progressively shorter periods of pain relief and results in a pattern of recurrent chronic headache. Headache pain ranges from moderate to severe and may occur with nausea or irritability. It may take weeks for these headaches to end once the drug is stopped.

Everyone with migraine needs effective treatment at the time of the headaches. Some people with frequent and severe migraine need preventive medications. In general, prevention should be considered if migraines occur one or more times weekly, or if migraines are less frequent but disabling. Preventive medicines are also recommended for individuals who take symptomatic headache treatment more than three times a week.

Above content provided by the National Institute for Neurological Disorders and Stroke in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted October 2009

Contact Information

Arnold Pain Management Center
Beth Israel Deaconess Medical Center
One Brookline Place, Suite 105
Brookline, MA 02445
617-278-8000
617-278-8065