Chronic migraine can be a serious burden, especially when traditional treatments don't seem to work. You may feel like there's no relief in sight. It's common to wonder: Is there anything else out there that might help?
"Many patients, particularly those with chronic migraine, experience feelings of defeat and discouragement at some point in their journey," says Kylie Gagan, registered nurse, director of education for the Association of Migraine Disorders. "The first step is to find a health care provider who is knowledgeable in diagnosing and treating migraine and also understands how impactful migraine can be to a person's daily life."
Fortunately, there are lesser-known treatments that may bring you relief. Below, learn about nontraditional, off-label, and combination treatments that show success in relieving migraine pain for some people. Talk to your doctor about whether one of these approaches may be right for you.
Most Common Meds for Migraine
Before diving into nontraditional treatments for migraine, it's important to know the mainstream options that are out there and how they work.
You've likely heard of the common acute treatments for migraine, such as triptans and nonsteroidal anti-inflammatory drugs (NSAIDs), and preventive options such as calcitonin gene-related peptide (CGRP) inhibitors, topiramate, and Botox.
Triptans
They are often prescribed first for migraine. They work by altering how blood circulates in your brain and how pain is processed. Triptans come in pill form, nasal spray, or injection. Common triptans for migraine are: almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, Onzetra, Tosymra), and zolmitriptan (Zomig).
NSAIDs
These medications work by blocking your body from making chemicals that cause inflammation and pain.
The most well-known NSAIDs for migraine pain are ibuprofen (Advil, Motrin) and naproxen sodium (Aleve, Anaprox), which are available over the counter. Other NSAIDs that have been "demonstrably effective in treating acute migraine," according to the American Migraine Foundation, include diclofenac potassium (Cataflam, Zipsor), diclofenac sodium (Voltaren), and indomethacin (Indocin).
CGRP inhibitors and Botox
You've probably also heard of CGRP inhibitors. CGRP stands for calcitonin gene-related peptide, a protein that transmits pain signals in your brain. CGRP inhibitors are medications that block this protein.
Two FDA-approved CGRP inhibitor treatments for migraine are erenumab (Aimovig) and fremanezumab (Ajovy) . Both treatments have been proven effective at lowering the number of headaches. Botox has been approved since 2010 for chronic migraine. It's injected into your body, where it enters nerve endings and blocks chemicals involved in pain transmission.
Off-label Treatments May Work Better Than You Think
Understandably, you may be wary about trying complementary or off-label treatments for your chronic migraine. In some cases, off-label and alternative medications have been shown to ease migraine pain.
According to the American Headache Society, many treatments that are not FDA-approved for migraine have established efficacy and probable efficacy for migraine.
Keep in mind that each treatment has its own risks and may work differently for each person.
What Alternative Treatments Might Work?
Some of the off-label treatments that have demonstrated success for migraine pain include beta-blockers, gabapentin, and memantine.
Gabapentin is an older medication commonly used to treat seizures and has shown some efficacy with migraine. The drug is thought to work by stabilizing nerve activity in your brain and reducing the release of neurotransmitters involved in pain signaling.
There's mixed data about whether gabapentin is helpful for migraine. Recent studies suggest there's significant evidence that gabapentin benefits chronic daily headaches, but the drug has only "some efficacy in migraine headache" and is not recommended as a primary therapy.
Memantine has shown more promising results for migraine. The drug affects a specific brain receptor involved in migraine attacks.
Memantine inhibits this receptor. A 2019 study found that memantine (10 mg oral, once daily) is effective, well-tolerated, and safe for those with migraine.
Beta-blockers are another off-label option. Propranolol is the most common beta-blocker used for migraine and is among the most effective, according to research.
But keep in mind that it may take up to 12 weeks for the therapeutic benefits of propranolol to work. Other beta-blockers to consider include atenolol, metoprolol, and timolol.
But don't take this group of medications if you have severe asthma, peripheral vascular disease, or severe bradycardia.
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) also show success as safe and effective alternative treatments for chronic migraine.
Researchers aren't entirely clear how ACE inhibitors improve migraine pain. They believe it relates to how ACE inhibitors interact with a peptide in your body that plays a part in pain and inflammation.
Studies show that the ACE inhibitor enalapril (Vasotec) significantly lowers migraine frequency and cuts headache severity by half for many people with migraine.
ARBs are a class of medications that stop the action of a certain hormone in your body. Deactivating this hormone allows your veins and arteries to relax.
People with migraine have reported positive effects from taking ARBs. Candesartan (Atacand), for instance, has been shown to reduce migraine days by at least 50%, while telmisartan (Micardis) has been shown to lower the number of migraine days by 38%, research shows.
What to Know About Injectables
When it comes to injectables, there are both preventive and acute treatment options available.
For stopping migraine attacks before they start, several CGRP monoclonal antibodies are FDA-approved for treatment, Gagan says. Monoclonal antibodies are proteins engineered in a lab to target certain cells or substances in your body. CGRP monoclonal antibodies target and block CGRP, a chemical believed to be linked to migraine attacks.
These include: erenumab, fremanezumab, and galcanezumab, which can be given as monthly or quarterly injections. Another CGRP monoclonal antibody, eptinezumab, is administered as a quarterly intravenous infusion, she says.
Injectable acute treatments can work to stop an attack already in progress, such as an attack that happens when you wake up in the morning, Gagan says.
For acute migraine treatment, consider dihydroergotamine and sumatriptan, both available using an injectable delivery method. Sumatriptan works by narrowing your blood vessels and blocking pain signals sent to your brain.
Similarly, dihydroergotamine can help ease migraine by tightening blood vessels in the brain and blocking the release of substances that can cause swelling.
You may also find relief with trigger point injections or nerve blocks. Trigger point injections involve a local anesthetic injected into a painful muscle to offer relief. If you have a specific trigger point that can be felt with a firm touch, you may get the most relief from this type of injection.
Nerve blocks, on the other hand, are injections of anesthetic medications near an occipital nerve in your body that can help with migraine pain relief. They may also include a steroid medication.
Supplements and Natural Remedies: Benefit or False Buzz?
It's common to see supplements and natural remedies marketed for easing headache pain, but do they really work?
Yes and no, according to the data.
Magnesium, coenzyme Q10, and riboflavin are among the most commonly used supplements for migraine prevention, Gagan says.
"Some studies suggest that regular use may help reduce migraine frequency or severity, though responses vary from person to person," she says. Supplements may be helpful for people looking for complementary approaches, those with other health conditions, or those who are sensitive to medications.
For example, one recent study found that IV magnesium reduced acute migraine attacks within 15-45 minutes, 120 minutes, and 24 hours after the initial infusion. Oral magnesium also lowered the frequency and intensity of migraine, the research showed.
Riboflavin also works well for some people. A 2022 analysis found that people who took 400 milligrams of riboflavin (also known as vitamin B2) per day for three months saw a major drop in the duration, frequency, and pain score of migraine attacks.
CoQ10 is another supplement showing success. CoQ10 stands for coenzyme Q10, and it is a natural antioxidant found in many foods, such as fish and vegetable oils. As recently as 2025, researchers concluded that CoQ10 supplements in a wide range of doses result in fewer and shorter migraine attacks, less nausea, and lower pain during a migraine attack.
Other supplements, such as vitamin D, have shown mixed results. While it's been proven that those with migraine often have lower vitamin D, it's not certain that supplements are the answer.
A 2025 study, for example, found that while vitamin D levels were lower in people with migraine, this didn’t appear to affect how often attacks occurred. Research suggests that low vitamin D may be a result of migraine, rather than a cause.
"Keep in mind that vitamins and supplements aren't regulated for safety or efficacy or approved by the FDA as migraine treatments," Gagan says. "Choose products from trusted brands that have third-party testing. Vitamins and supplements can have side effects or interact with medications, so it’s important to talk with your health care provider before starting anything new."
Also remember, it may take three to four months of consistent use of vitamins or supplements to start seeing a decline in migraine attack frequency and/or severity, she says.
New Advances, Possible Combination Therapy
Medication isn't the only option that may solve your chronic migraine symptoms. New medical tools you may want to consider are neuromodulation devices.
These devices can enhance or block activity in your nervous system and have been shown to stop migraine attacks in progress or stop them from happening. Early research shows neuromodulation devices can help treat migraine attacks and cluster headaches.
"Neuromodulation has been proven safe and effective as acute and preventive treatment," Gagan says. Some of the FDA-cleared devices include Cefaly, GammaCore, Nerivio, Relivion MG, and Savi Dual.
To learn more, she suggests asking your provider about drug-free, needle-free neuromodulation devices for migraine.
Combining two or more therapies may also be your best bet. Taking NSAIDs and triptans together may make them more effective, according to some studies.
One combo that has also shown strong efficacy is that of acetaminophen, aspirin, and caffeine.
Medication combinations, also called "migraine cocktails," can widely differ depending on the individual. In some cases, magnesium, nausea medication, diphenhydramine (Benadryl), and dihydroergotamine may be the right mix that soothes your pain, according to the American Migraine Foundation.
Gagan knows firsthand the potential for combination therapies. At one point during her migraine journey, she used a daily preventive medication, received onabotulinumtoxinA injections quarterly, took a triptan with an NSAID for acute attacks, had a gepant available if needed, and used two different neuromodulation devices.
"I also had a third preventive medication I could add on if necessary, as well as another treatment on standby for status migrainosus — an attack lasting more than 72 hours," she says.
"Having an arsenal of treatment options has been essential for me, and it’s why finding a headache specialist or a provider who is knowledgeable about treating migraine is so important."
What Should You Ask Your Provider About Alternative Treatments?
Before taking any new or off-label treatments, talk to your health care professional about the potential side effects and any interactions with other medications or health conditions, Gagan says.
Other good questions to ask include: Does the treatment show success with migraine? What's the proper dosing? How often should the treatment be used? How long does it take to start working? And when should I schedule a follow-up visit to discuss the new treatment?
Your health care provider can help address your concerns and guide you on the best direction to take. Sometimes, finding relief may require two or more treatment approaches, says Gagan.
That's why it's important not to give up, even when you're feeling hopeless about your migraine pain.
"It can get better, and you deserve better care," Gagan says. "If your current provider isn't able to help you, don't hesitate to seek a second opinion from a neurologist or headache specialist. There are more effective treatment options for migraine than ever before."
