A staggering range of potential migraine medications exist. Depending on the severity of your migraine symptoms, you may be advised to take over-the-counter analgesics, prescription medications designed to quickly relieve symptoms (Amerge and Imitrex are two common migraine-specific medications), or even long-term medication to prevent headaches from developing. Recent research has even revealed that injections of the botulism toxin (botox) can relieve migraine pain.
Non-Prescription Analgesics
If you experience mild to moderate migraine pain, chances are good that your first treatment option will be an over-the-counter analgesic, such as aspirin or acetaminophen. To be most effective, the medication should be taken as soon as symptoms are noticed.
Unless advised to by your doctor, never take more than the recommended dosage. Taking analgesics more than three times a week increases the risks of developing rebound headaches from the medication. Side effects of the painkillers themselves are usually minor, but can include nausea, stomach problems, diarrhea and drowsiness.
Another option is the use of NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs treat migraines by relieving both pain and inflammation. For mild headaches, some NSAIDs, ibuprofen or naproxen, for example, are available without a prescription.
Migraine Medications and Side Effects
The information on this page includes the more common side effects of various medications. Less common side effects are not listed. Ask your health professional for a complete list of side effects for any medication you are prescribed.
Amerge, Imitrex and Other Triptans
The triptan drug group is a popular choice for moderate to severe migraine pain. Triptans affect the brain’s level of serotonin, which in turn affects the brain’s perception of headache pain. In addition, triptans narrow blood vessels in the brain, which reduces the pressure put on pain sensitive areas.
Amerge and Imitrex are two of the more well known triptans, but a variety of others exist, including Zomig, Maxalt and Axert. They are available in tablet form, as injections, and as nasal sprays. The nasal sprays can be quite ill tasting. Side effects include a warm, tingling sensation, dizziness, vomiting or nausea, and a feeling of tightness in the chest.
As with any other abortive medication (that is, any medication that treats a migraine after it has begun), triptans are best taken as early into the migraine as possible. If the first dose proves ineffective, some triptans can be taken a second time after about four hours, an advantage over many other types of medication.
Preventative Options
Individuals whose migraines do not respond well to abortive medications may be prescribed a preventative medication. Many such prescriptions are long-term, lasting for months, or even years. Tricyclic antidepressants, the hypertension-reducing beta-blockers and calcium channel blockers, while all developed for other medical conditions, are often used to prevent migraines. Some patients find that their migraines are fully prevented, while others experience them less frequently, and with less intensity.
The anti-seizure medication divalproex sodium (Depakote) was originally developed to treat epilepsy, but has proven to be a very effective migraine preventative as well. Depakote’s main side effects are stomach problems and fatigue. It should not be taken during pregnancy, as it can damage a developing fetus. If taken by children under ten years old, Depakote can also cause serious liver damage.
Several types of preventative medications can cause unwanted complications or withdrawal symptoms if stopped suddenly. To avoid complications or rebound headache, you may need to slowly reduce the level of medication taken. Consult your doctor before stopping any prescription drugs.
Botox: Relief Through Poison?
The botulism toxin is one of the most powerful toxins known to science, but recent research indicates it may have applications in migraine care. Botulism injections (commonly called botox) have been used cosmetically to remove facial wrinkles. Migraineurs who underwent this treatment reported up to three months of headache relief after botox injections. Recent clinical trials have supported these claims, although the FDA has yet to formally acknowledge the use of botox for the treatment of severe headaches.
Emergency Room
Severe migraine pain may lead to hospitalization. If so, you may be treated with narcotics for pain relief. Narcotics are generally not prescribed outside of a hospital setting due to their habit-forming properties, and the extreme drowsiness that often results from their use. Nausea-preventing medications, or corticosteroids to reduce inflammation, may also be administered.