But choosing your best treatment is not as simple as opening the medicine cabinet and grabbing a pain reliever. You need to discuss the symptoms, as well as the duration and frequency, of your migraines with your doctor. Together, you can select a treatment that helps reduce your pain and may even help prevent or at least reduce your migraine attacks.
Before talking with your doctor, here are 11 facts about common migraine medication that may help you get the most out of your next appointment. The facts below will also help you provide your doctor with the information necessary to deliver the best results while protecting you from adverse reactions.
1. Start Small
When starting any treatment using migraine medication, always start slowly and increase doses and strength of medications gradually. Lower strength over-the-counter medications and low dosages may help you avoid many drug side effects. Gradually increase strength and dosage as needed and as your physician recommends.
2. Share Your History
Before taking any migraine medication, share your medical history with your physician. To prevent potentially dangerous results, your doctor needs to know if you are pregnant, have other medical disorders or are taking any medications. Even over-the-counter medications can aggravate existing conditions, especially when taken in conjunction with other medications.
3. Understand the Drug Categories
Migraine medications fall into two basic categories: 1) relief from pain and other migraine symptoms and 2) prevention or reduction of the duration and frequency of migraine attacks.
4. Medications Reduce Swelling and Pain
Both over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) work the same way—to block the enzymes that produce prostaglandins in order to reduce swelling and pain. Both help relieve pain. Prescription NSAIDs may offer stronger anti-inflammatory treatment.
5. Talk with Your Doctor about Natural Supplements
If you are already taking supplements or using natural treatments for migraines, such as essential oils and herbs (feverfew and butterbur), talk with your physician before taking migraine medications. The combination may cause complications.
6. Anti-Seizure Medications May Help
Anti-seizure drugs have been shown in studies to reduce the frequency of both episodic and chronic migraines.1
7. BOTOX® for Prevention
Since receiving FDA-approval for migraines in 2010, Botox (botulinum toxin) has shown to be effective for many as a migraine treatment. Treatments for this use are given once every three months for a 15-month period by injection in specific points in order to reduce migraine headache symptoms.2
8. Opiates and Opioids Relieve Pain
Opiates and opioids (narcotic analgesics) such as codeine and oxycodone are very effective pain relievers for short-term use. However, over time patients build tolerance and require larger and more frequent dosages. These are highly addictive medications.
9. Drugs Can Constrict Blood Vessels
Triptans have largely supplanted ergots for migraine pain relief. Both work by constricting blood vessels. Doctors recommend taking triptans at the first indication that a migraine is coming on. Both triptans and ergots have side effects.
10. Aspirin and Acetaminophen Can Relieve Pain
Both aspirin and acetaminophen are common migraine medicines. In addition to pain relief, aspirin is an anti-inflammatory. When taken over an extended period, however, aspirin may lead to stomach problems, bleeding and ulcers. One solution may be to use aspirin with an enteric coating to help protect your stomach. Your second option may be to take acetaminophen. While acetaminophen has side effects (nausea, diarrhea, swelling and liver damage) taking low dosages may be effective and will reduce chances of serious side effects.3 Discuss your options with your doctor.
11. Withdrawal Can Cause Rebound Headaches
When taken in large dosages over a long period, virtually any medication may contribute to rebound or Medication Overuse Headaches (MOH). To avoid overuse, misuse or rapid withdrawal (stopping cold turkey), your doctor can recommend a safe dosage. Follow your doctor’s advice, including a plan for gradual withdrawal.
For the best and safest results, take all migraine medication as your physician prescribes and recommends.
1 Naegel S, Obermann M. “Topiramate in the prevention and treatment of migraine: efficacy, safety and patient preference.” Neuropsychiatr Dis Treat., http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951059/. Accessed April 4, 2016.
2 “Does Botox Help Treat Chronic Migraine?” http://www.healthline.com/health/migraine/does-botox-help-treat-chronic-migraine. Accessed April 4, 2016.
3 Cameron C, Kelly S, Hsieh SC, et al. “Triptans in the Acute Treatment of Migraine: A Systematic Review and Network Meta-Analysis.” http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072552/. Accessed April 4, 2016.
BOTOX® is a registered trademark of Allergan.