Chronic migraine is a common condition that costs lost productivity, lower quality of life, overall discomfort, and pain. Most migraine symptoms are treated after managing the pain rather than preventing the attack.
Frequent, severe migraines are best managed when treated preventively. Taking medications in a timely manner, making changes to your diet and lifestyle, and avoiding migraine triggers can help give you the most relief from migraine pain. Depending on the severity of symptoms, your doctor may have you on prescription medication, or you pay attention to onset pain and treat individual migraine headaches. Treatment can include a variety of medications.
While medications can be great for preventing pain, you could take too many medicines, which causes frequent primary headaches. These are headaches with no underlying cause and result from overusing quick-response headache medications.
This medication overuse can happen if you avoid or delay taking medication when you start experiencing a migraine. You may wait because you’re unsure if you have a migraine attack, or you only want to take medicine once the pain becomes unbearable. However, research has shown that your best treatment is taking medication early when you first feel a migraine coming on.
To get the best results from your migraine medication, you can break down each type of therapy into different treatment levels.
1. First Level of Treatment
Acetaminophens and NSAIDs. When you experience mild to moderate migraine pain, you should start with nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen. Taking acetaminophen-based drugs can also help. Acetaminophen might be less effective than NSAIDs, but it doesn’t harm your stomach lining.
Triptans. Another effective treatment for moderate to severe migraines is triptans. They work best when taken early on during a migraine attack. Sumatriptan is the most studied triptan, and how effective it depends on dosage and type of administration. Triptans are adequate but are a more costly treatment than acetaminophens and NSAIDs.
2. Second Level of Treatment
These types of treatments can have more adverse effects, so they’re not recommended to start with. Intranasal dihydroergotamine has been very effective, but nausea is a common side effect. This treatment can also cause legs cramps or tingling in your arms and legs. You aren’t advised to use it if you’re pregnant.
Other second-level treatments include:
- Opioids
- Antiemetics
- Promethazine
- Other dopamine antagonists
If you’re not finding relief from first-level migraine treatment, your doctor will need to prescribe you a second-level treatment. You should monitor how these medications make you feel. If you’re experiencing any adverse effects, talk to your doctor immediately. Some of these medications can be highly addictive and have high abuse potential.
Timing is essential when managing your migraine pain. Keeping a journal to track symptoms and triggers will help you identify when you have a migraine attack. This will help you turn to the proper medication to alleviate the pain.
