Medication Treatments for Migraines

Various medications can help relieve migraine symptoms, such as pain and nausea. They are available over-the-counter or by prescription and come in different forms, including pills, injections, and nasal sprays.

Over-the-counter pain medications

Over-the-counter (OTC) pain medications can be used to relieve mild to moderate migraine pain. Examples include ibuprofen, acetaminophen and naproxen. Some OTC medications contain a combination of pain relievers, such as aspirin, acetaminophen and caffeine, which may help reduce migraine symptoms.

Prescription migraine medications

Several classes of prescription medications are effective in reducing migraine pain and other migraine symptoms. These include, but are not limited to, the following:

• Triptans work by increasing levels of serotonin in the brain, constricting blood vessels, and reducing inflammation. Examples include sumatriptan and rizatriptan. Triptans are available in different forms: tablets, oral disintegrating tablets, injections, or nasal sprays.
• Ergots only work on headaches that involve throbbing pain. They can be used during a migraine aura or for migraines that have lasted two or more days. Ergots work by narrowing widened blood vessels to reduce throbbing pain. An example is dihydroergotamine. Ergots are available in different forms: tablets or nasal sprays.
• Glucocorticoids are a specific class of corticosteroids; they are often used when migraines do not respond to other medications. Examples include prednisone and dexamethasone.
• Lasmiditan is the first medication in a new class of drugs called “ditans.” It works similarly to triptans; however, it does not have the same restrictions as triptans because it does not cause blood vessels to narrow. It can be taken during an aura and can reduce pain, nausea, and sensitivity to light and sound.
• Calcitonin gene-related peptide receptor antagonists work as antagonists to calcitonin gene-related peptide (a protein in the body that is directly related to migraine pain) receptors. Ubrogepant is the first CGRP receptor antagonist approved to treat an active migraine.

Prescription pain medications

If over-the-counter pain relievers and other migraine medications are ineffective, prescription pain medications may be prescribed. Examples include codeine, oxycodone and hydromorphone.

Anti-nausea medications

If nausea or vomiting is an issue during migraine attacks, anti-nausea medications or antiemetics may be prescribed. Examples include chlorpromazine, metoclopramide or prochlorperazine. These can typically be taken in conjunction with pain medication.

Since such a wide variety of medications are available to treat migraine attacks, it is important to work with a health care provider to identify the most effective individualized treatment. If four or more migraine attacks occur per month or pain-relieving medications are ineffective, preventive medication for migraines may be necessary.