How is migraine treated?
Currently, there is no cure for migraine but usually it can be treated effectively with drugs. Simple painkillers available over the counter, such as acetaminophen, aspirin (Bayer) and ibuprofen (Advil), will be effective in many cases. If not, a combined product also containing codeine may work and may be particularly useful if diarrhea is a symptom. Prochlorperazine, promethazine, and metoclopramide (Metozolv ODT, Reglan) are agents that are available to treat nausea. If stronger painkillers and/or anti-nausea  drugs are required, your doctor can prescribe them for you. The newest agents for the acute treatment of migraine are the triptans. This class of drugs is available only by prescription and includes almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex) and zolmitriptan (Zomig). In certain cases a combination of sumatriptan and naproxen (Treximet) may also be prescribed. These drugs can help even when an attack has already started. Other treatments your doctor may prescribe include those containing ergotamine. If you suffer from more than two migraine attacks a month and are suffering significant disruption to your life as a result your doctor may prescribe a preventative drug to be taken regularly. This is usually a beta-blocker such as metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), propanolol (Inderal) or timolol. Clonidine may also be prescribed for the prevention of migraine.

Botulinum toxin (Botox) is a different type of preventative for people who have frequent attacks. It is injected into muscles in the head and neck to block the release of pain-causing chemicals.

Self-help measures
Keep a diary and try to identify any pattern in attacks as this may help to identify any trigger factors. You will need to record all your daily activities, what you eat and drink, the weather, your mood, any attacks and symptoms and any medications you take. You may then be able to prevent attacks by avoiding any trigger factors identified. However, while useful, this is not a fail-safe method as the trigger factors may not always be your control. Stress is a significant trigger for migraine and stress management can be very beneficial. Relaxation techniques and changing daily routines can improve your stress levels.

Further information
National Institutes of Health’s National Institute of Neurological Disorders and Stroke: www.ninds.nih.gov/disorders/migraine/migraine.htm

Last Reviewed: May 2013