When Treatments for Migraine Don't Work

When your migraine treatments don't work well, it's frustrating but not uncommon. Many people try several approaches before finding relief. If your current plan isn't helping, it's time to reassess with your doctor. Track your headaches, symptoms, and response to treatments to help identify patterns and guide next steps.

Using pain relievers too often (more than 10-15 days per month) can backfire and cause more headaches. This rebound effect makes migraines worse and harder to treat. If you're taking pain medications frequently, your doctor might recommend a "detox" period to break the cycle and reset your treatment approach.

Taking migraine medications too late can reduce effectiveness. Triptans and other acute treatments work best when taken at the first sign of a migraine, not when pain becomes severe. If you're waiting until your headache is unbearable, try taking medication earlier in your next attack.

If you have frequent migraines, preventive medications might help. These are taken daily to reduce headache frequency and severity. Options include blood pressure medications, antidepressants, anti-seizure drugs, and CGRP inhibitors, which block a protein that plays a role in migraine pain. Unlike acute treatments, these work over time.

Devices that stimulate nerves can offer relief without medication. Also called neuromodulators, these devices can treat an acute migraine already in progress or help prevent migraines. They use electric currents or magnetic action to tamp down the brain waves that set off migraines. Some devices are portable, but other types are implanted with surgery. They may be a good option for you if migraine medications haven't worked or you overuse medications without getting pain relief.

Sometimes treatments fail because triggers keep activating migraines. Common culprits include certain foods, stress, irregular sleep, hormonal changes, and weather shifts. Keep a detailed diary of your activities, diet, and environment before migraines to identify patterns you can address.

Poor sleep quality, high stress, and irregular routines can undermine migraine treatments. Establish consistent sleep and mealtimes, practice stress-reduction techniques like meditation or yoga, and incorporate regular, moderate exercise. These changes can make your medications more effective.
 

If your primary care doctor's treatments aren't working, a headache specialist might offer more targeted approaches. These neurologists have specific training in headache medicine and can develop more sophisticated treatment plans, including combination therapies or newer options.

Finding effective migraine relief often takes time and persistence. New treatments are constantly emerging, including CGRP medications, neuromodulation devices, and innovative combinations of existing therapies. What doesn't work now might be supplemented by something that does in the future.