What medications can I take to treat and prevent acute migraines?

The medication for migraines can be either for acute treatment of headache pain or for prevention (treatment of the underlying causes of the headaches). Medication for prevention is used daily by women who have very frequent headaches (usually more than two or three per month) or have severe headaches. For mild to moderately severe migraines, over-the-counter medication has been found to be effective.

These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen sodium. Caffeine can also be helpful; however, sometimes too much caffeine can make the headache worse. Medication for acute treatment is more effective when used early.

Earlier treatment also leads to less severe headaches and fewer accompanying symptoms. Sometimes, you are reluctant to treat a headache until you are sure it is a migraine; but this allows the headache to become more severe and makes treatment less effective. The simplest treatment is high-dose NSAIDs, which are effective for many women.

Of all the prescription medications that are used to treat acute headaches, the newest and most widely used is a group of medications called triptans. All these drugs fall into two categories: those that take effect more quickly and wear off more quickly, and those that take longer to take effect but are effective longer. The drugs also vary with regard to adverse effects, and so the choice of triptan depends on individual women.

Triptans can be administered by different routes: for example, sumatriptan may be taken as a pill, by injection, or in a nasal spray. Rizatriptan can be taken as a disintegrating tablet that dissolves in the mouth.

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