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What are migraine headache medications?
Migraine medications are for treating migraine headaches and associated symptoms. Migraine medications do not cure migraines, but relieve migraine symptoms and reduce the frequency and intensity of the migraines. Some migraine pain relief medications are available over the counter, but most are prescription medicines.
What are migraine headaches?
Migraine is a neurovascular disorder marked by physiological changes in the brain that cause a collection of symptoms including intense, debilitating headaches, that may last from several hours to days. The cause of migraine is not fully clear. Migraines are possibly hereditary, and the majority of sufferers are women. In some women, migraines may be cause by hormone fluctuations during the menstrual cycle.
Current research suggests that migraine pain may be initiated by overactive nerve cells (neurons) triggering the trigeminal nerve, which provides sensation to the head and face. This leads to an imbalance in certain chemical messengers (neurotransmitters) in the brain resulting in a migraine headache.
The two neurotransmitters involved in migraines are:
- Serotonin: A hormone that plays many roles, including mood regulation, sleeping and digestion. Serotonin constricts blood vessels, and a sudden fall in serotonin levels at the start of a migraine makes blood vessels in the brain swell, resulting in inflammation and pain.
- Calcitonin gene-related peptide (CGRP): CGRP is a small protein involved in transmission of pain signals. CGRP is released by the trigeminal nerve during a migraine headache.
In some people, migraine headaches may be preceded by warning signs known as auras, the symptoms of which may vary from flashing lights, transient blindness, to weakness or numbness on one side of the body. Migraine headaches may be triggered by many factors such as hormone fluctuations, certain foods or drinks, and stress.
Common symptoms of migraine include:
What are the different types of migraine medications?
Migraine medications are of two major types (some medications are both types):
Abortive medications relieve the symptoms of acute migraines. Abortive medications are taken at the first sign of a migraine attack. Acute migraine attacks not relieved by abortive therapy and lasting longer than 72 hours should be treated in the emergency department.
Types of abortive medications include:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Ergot alkaloids
- Triptans (serotonin receptor agonists)
- CGRP antagonists
- Antinausea medications
- Other pain relievers
Preventive medications are usually taken daily by people with chronic migraine. Migraine is considered chronic when a person has migraine headaches 15 or more times in a month. Preventive medications reduce the frequency and severity of migraines, but may take up to six months to produce maximal effects.
Most preventive medications are not specifically migraine-targeted, but medications that treat other conditions, which clinical trials have found to be effective for migraines. Women who have menstrual migraines may respond to hormone therapy, in addition to preventive or abortive therapy.
The American Headache Society and the American Academy of Neurology recommend the following types of medications for treating chronic migraine:
How do abortive migraine medications work?
NSAIDs block the production of the chemicals that cause inflammation and pain. NSAIDs only relieve pain and do not address the changes in the brain that cause migraine. Most NSAIDs are available over the counter. Following are some of the NSAIDs used for migraines:
- Ibuprofen (Advil, Motrin) -- dosage of 400 mg and above require prescription
- Acetaminophen, paracetamol (Tylenol)
- Naproxen sodium (Aleve, Anaprox DS [prescription] and Naprosyn [prescription])
- Combination of aspirin, acetaminophen, caffeine (Excedrin migraine)
- Ergot alkaloids provide pain relief by constricting blood vessels. Ergot alkaloids include:
- Ergotamine tartrate (Ergomar sublingual tablet)
- Dihydroergotamine mesylate (D.H.E. 45 injection, Migranal nasal spray)
- Ergotamine tartrate/caffeine (Cafergot)
Triptans are serotonin receptor agonists which boost serotonin activity. Triptans constrict blood vessels, reduce inflammation and relieve pain. Triptans include the following:
- Sumatriptan succinate (Imitrex, Zembrace, Onzetra inhaled, Tosymra nasal spray)
- Sumatriptan/naproxen (Treximet)
- Zolmitriptan (Zomig)
- Rizatriptan benzoate (Maxalt)
- Naratriptan hydrochloride (Amerge)
- Almotriptan malate
- Frovatriptan succinate (Frova)
- Eletriptan hydrobromide (Relpax)
Ditans are a new type of medication for acute migraines. Ditans also works on serotonin receptors, but bind to a specific subtype of serotonin receptors which block the release of CGRP by the trigeminal nerve. Ditans may be a better option for people with cardiovascular disease because it does not constrict blood vessels. The FDA-approved ditan is:
- Lasmiditan succinate (Reyvow)
- CGRP antagonists
- Calcitonin gene-related peptide antagonists work by preventing CGRP from transmitting pain signals. CGRP antagonists include:
- Rimegepant sulfate (Nurtec ODT)
- Ubrogepant (Ubrelvy)
Antinausea medications relieve nausea and vomiting caused by migraines. These symptoms may be relieved with migraine medications, but for some people they may be severe enough to prevent them from taking migraine medications.
Antinausea medications are available in the form of injections, tablets, capsules, syrup, and as rectal suppositories for people unable to ingest them orally.
Antinausea medications for migraines include the following:
- Promethazine hydrochloride
- Chlorpromazine hydrochloride
- Prochlorperazine (Compro)
- Trimethobenzamide hydrochloride (Tigan)
- Metoclopramide hydrochloride (Reglan)
Other pain relievers
- Barbiturate, a sedative, may be prescribed in combination with an NSAID, with or without an opioid (narcotic). A barbiturate combination often used for migraine is:
- Butalbital/acetaminophen/caffeine with or without codeine (opioid)
- Opioids are more potent painkillers but sparingly prescribed because they carry a serious risk of addiction.
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How do preventative migraine medications work?
NSAIDs used for migraine prevention include:
- Amitriptyline hydrochloride
- Nortriptyline hydrochloride
- Imipramine hydrochloride
- Doxepin hydrochloride (Silenor)
- Protriptyline hydrochloride (Vivactil)
Selective serotonin reuptake inhibitors maintain normal levels of serotonin by preventing their reuptake. Reuptake refers to the normal reabsorption of neurotransmitters by neurons after the completion of nerve signal transmission.
Serotonin-norepinephrine reuptake inhibitors prevent reuptake of both serotonin and norepinephrine, another hormone which helps reduce the intensity of the headache. SNRI antidepressants used for migraine include:
High blood pressure medications
High blood pressure (HBP) medications work in various ways to relax the smooth muscles around the heart and blood vessels to reduce blood pressure. Types of HBP medications prescribed for migraines include:
- ACE inhibitors
- Calcium channel blockers
Anticonvulsant medications reduce the electrical activity in the brain and bring down the pain. Anticonvulsants prescribed for migraines include:
Calcitonin gene-related peptide inhibitors bind to CGRP receptors and block their activity. CGRP inhibitors are the newest preventive medications specifically developed for treating chronic migraines. CGRP inhibitors are monoclonal antibodies administered as monthly or quarterly injections.
CGRP inhibitors include:
- Erenumab (Aimovig)
- Fremanezumab (Ajovy)
- Galcanezumab (Emgality)
- Eptinezumab (Vyepti)
Botulinum toxin type A
Botulinum toxin type A is a purified enzyme produced from the bacteria Clostridium botulinum. Botulinum toxin type A is used to treat a number of muscle disorders and relax overactive muscles by blocking a neurotransmitter known as acetylcholine.
It is not fully understood how Botulinum toxin type A works in relieving migraine pain, but it is thought to inhibit the pain pathways of the trigeminal nerve. Botulinum toxin type A injections are given quarterly and the medication prescribed for migraine is:
What are complementary and alternative therapies for migraines?
Though scientific evidence of efficacy is not established with quality studies for may of the following remedies, some migraine patients may find benefit from complementing medications with alternative therapies such as:
- Yoga and meditation
- Chiropractic therapy
- Craniosacral therapy
In addition to medications, migraines can be managed by adopting lifestyle habits such as:
Additional Information on Types of Migraine Medications
Warning: Triptans should not be taken with SSRI or SNRI antidepressants, it may lead to a life-threatening condition called serotonin syndrome.
- Please visit our medication section of each drug within its class for more detailed information.
- If your prescription medication isn’t on this list, remember to look at MedicineNet.com drug information or discuss with your healthcare provider and pharmacist.
- It is important to discuss all the drugs you take with your doctor and understand their effects, possible side effects and interaction with each other.
- Never stop taking your medication and never change your dose or frequency without consulting with your doctor.
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Migraine medications are for treating migraine headaches and associated symptoms. Migraine medications do not cure migraines, but relieve migraine pain and reduce the frequency and intensity of the migraines. Some migraine pain relief medications are available over the counter, but most are prescription medicines.
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Related Disease Conditions
Abdominal Migraines in Children and Adults
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Abdominal Migraines in Children and Adults
Abdominal migraine in adults and children is a variant of migraine headaches. Abdominal migraine in children generally occurs in children who have a family history of migraines. Causes of abdominal migraine is not known. Symptoms of abdominal migraine include acute, severe, midline abdominal pain, nausea, vomiting, paleness, and inability to eat. Abdominal migraine is diagnosed through patient history, family history, and ruling out other medical causes. Treatment of abdominal migraine include tricyclic antidepressants and triptans.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine. Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain. Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure. Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Migraines and Seizures (Symptoms, Auras, Medication)
Migraines are a type of headache and seizures are the main symptom of epilepsy. Migraine headaches and seizures are two different neurological problems that have similar signs, symptoms, and auras, for example, sensitivity to light (photophobia) and sound, irritability, nausea, and vomiting. Symptoms unique to migraine and migraine auras are water retention, problems sleeping, appetite changes, and talkativeness. Symptoms unique to seizure and seizures auras are depression, a feeling of heaviness, a feeling that a seizure is approaching, and depression. Many of the symptoms of migraine and seizures are the same, however, seizures do not cause migraines; however, people who have seizures are twice as likely to have migraines and vice-versa. People who have migraines are twice as likely to have seizures, and people with seizures are twice as likely to have migraines; however, one condition does not cause the other.
Migraine and Stroke
Migraine headache is a type of headache in which the exact cause is not known; however, they may be inherited, and certain foods and environmental factors can trigger and may contribute them. A stroke (brain attack) happens when a blood vessel in the brain leaks, bursts, or becomes blocked, which can be caused by many other health problems. Both migraines and strokes can can cause severe head pain (migraine pain usually is only on one side of the head). Migraine aura symptoms may mimic or feel like a stroke or mini-stroke (transient ischemic attack, TIA) because they have similar symptoms and signs like severe headache, numbness in the legs, feet, arms, hands, or face, nausea, vomiting, and dizziness. Other migraine aura symptoms include vision problems like flashing lights or blind spots in one eye. The main difference between migraine headache and stroke symptoms and signs is that a migraine headaches usually come on gradually while a stroke symptoms come on suddenly and unexpectedly.
What Causes Migraines?
A migraine is a complex disorder that involves episodes of recurrent and severe headaches. An episode of a migraine can be very painful, lasting for hours, making day-to-day activities difficult until the episode is resolved. The frequency and severity of migraine attacks tend to decline with age. And women are more likely to suffer from migraines than men.
What Are the First Signs of a Migraine?
The first sign of a migraine is severe eye pain associated with a dull headache. Migraines gradually worsen with physical activity.
How Do You Get Rid of a Migraine Fast?
Migraine is a neurological condition that is characterized by recurrent episodes of intense headaches. It may be associated with symptoms such as nausea, vomiting, and other clinical features.
What Causes Migraines in Women?
Migraine is most commonly seen in women. Every three out of four women are affected by migraines. Some of the most common triggers affecting women are changes in hormonal levels or birth control pills, lack of sleep or too much sleep, and others
How Long Do Migraines Last For?
Migraines typically last from four to 72 hours. The frequency of migraines differs for everyone, but usually, there would be two to four headaches per month. In some, the migraines may occur every few days, while others may get them once or twice a year.
What Is the Most Common Type of Migraine?
The most common type of migraine is migraine without aura (common migraine). 70-90% of people with migraine experience this type. The frequency of this type of migraine may range from once a year to several times per week.
What Is the Best Cure for Migraine?
The best cure for migraine involves preventive medications and lifestyle changes. Some newer medications and therapies are effective in controlling the symptoms of migraine. Avoiding or controlling triggers may provide considerable benefit. Migraine can be prevented mainly by using medications, avoiding triggers and implementing lifestyle changes.
Treatment & Diagnosis
Medications & Supplements
- aspirin - oral, Easprin, Ecotrin
- acetaminophen - oral, Panadol, Tylenol
- metoclopramide - oral, Reglan
- zolmitriptan disintegrating tablet - oral, Zomig ZMT
- naproxen sustained-release - oral, Naprelan
- naproxen suspension - oral, Naprosyn
- zolmitriptan - oral, Zomig
- naproxen enteric-coated tablet - oral, EC-Naprosyn
- sumatriptan spray - nasal, Imitrex
- sumatriptan tablet - oral, Imitrex
- promethazine - injection, Phenergan
- zolmitriptan spray - nasal, Zomig
- sumatriptan succinate - subcutaneous injection, Alsuma, Imitrex, Sumavel DoseP
- eletriptan - oral, Relpax
- acetaminophen (Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain)
- aspirin (acetylsalicylic acid, Bayer, Ecotrin, and others)
- sumatriptan, Imitrex, Alsuma, Imitrex STATdose System, Sumavel DosePro
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- metoclopramide, Reglan, Metozolv ODT, (Reglan ODT, Octamide, and Maxolon
- promethazine, Phenergan, Phenadoz, Promethegan
- zolmitriptan (Zomig, Zomig-ZMT)
- eletriptan, Relpax
- ergotamine - sublingual, Ergomar
- trimethobenzamide - oral, Tigan
- frovatriptan - oral, Frova
- almotriptan - oral, Axert
- dihydroergotamine - injection, D.H.E.45
- trimethobenzamide - injection, Tigan
- chlorpromazine - oral, Thorazine
- naratriptan - oral, Amerge
- prochlorperazine - injection, Compazine
- dihydroergotamine - nasal, Migranal
- ergotamine/belladonna/phenobarbital - oral, Bellergal-S
- prochlorperazine (Compazine, Compro)
- prochlorperazine - oral, Compazine
- ergotamine/caffeine - oral
- chlorpromazine-injection, Thorazine
- Aleve (naproxen) vs. Celebrex (celecoxib)
- Aspirin vs. Aleve (Naproxen)
- Ondansetron (Zofran) vs. metoclopramide (Reglan)
- Haldol (haloperidol) vs. Thorazine (chlorpromazine)
- Side Effects of Zomig (zolmitriptan)
- Side Effects of Compazine (prochlorperazine)
- Side Effects of Phenergan (promethazine)
- Side Effects of Phenergan with Codeine (promethazine and codeine)
- Side Effects of Reglan (metoclopramide)
Migraines and Headaches Resources
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