Table of ContentsView AllTable of ContentsWhat Is a Migraine?CausesPreventative MedicationsMedicine for Migraine OnsetManagement and PreventionWhen to Seek HelpFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

What Is a Migraine?

Causes

Preventative Medications

Medicine for Migraine Onset

Management and Prevention

When to Seek Help

Frequently Asked Questions

Different types of medications are used to treatmigraine headaches, depending on the level of pain you are experiencing and the frequency of your migraines. Some medicine can prevent migraines, while others treat current symptoms. Read more about the most common types of medicine used for migraine treatment.

AsiaVision / Getty Images

Young Asian woman sitting on bed and feeling sick, taking medicines in hand with a glass of water - stock photo

Migraines areprimary headache disorders, in which headaches arise independently of other illnesses or diseases. Lasting anywhere from four to 72 hours or more, migraine attacks can cause a broad range of symptoms.

Typically, migraine attacks come in phases, changing features as they progress. Here’s a breakdown:

The frequency of migraine attacks can vary a great deal. However, people who experience 15 or more attacks a month are considered to havechronic migraine.

Causes of Migraine Headaches

Migraines are believed to arise from waves of increased activity in certain brain cells, which causes the release of the hormonesserotoninandestrogen. As a result, blood vessels supplying the brain become narrowed, which leads to headache and the other symptoms.

While the exact reasons someone may develop migraines are unknown, several risk factors have been identified:

What Triggers a Migraine?

In addition, other triggers include:

Medications Used to Prevent Migraines

Along with making certain lifestyle changes and working to prevent exposure to triggers, medications play a central role in migraine management. Broadly speaking, medicine for migraine can be divided into “prophylactic” medications that prevent and minimize attacks, and “abortive” medications, which manage symptoms after onset.

Several classes of drugs are prescribed aspreventive migraine therapy; these are generally considered if migraines are occurring multiple times a month.

Beta-Blockers

Among the most widely prescribed drugs for migraine arebeta-blockers, which are also used forhigh blood pressure(hypertension),cardiac arrhythmia(irregular heartbeat), and other heart or circulation issues. Most common of these are Tenormin (atenolol), Inderal LA (propranolol), or Toprol XL (metoprolol), but there are many others.

Though effective, these can cause some side effects, including:

Tricyclic Antidepressants

Another class of drugs used to prevent migraine aretricyclic antidepressants. Also used to treat depression and anxiety, amitriptyline, Pamelor (nortriptyline), and Silenor (doxepin) are frequently considered options.

Common side effects of these medications include:

In addition, rare adverse effects are:

Antiepileptic Drugs

Typically used to treat seizures,antiepileptic drugssuch as Depakote (valproic acid) and Topamax (topirimate) can help prevent migraine onset. As with other medications, antiepileptic use can lead to some side effects, including:

Guide to Anti-Epileptic Drugs

Calcium Channel Blockers

Calcium channel blockers are typically used to reduce blood pressure. However, they may also be considered for migraine, though evidence for efficacy is mixed. The calcium channel blocker verapamil, a generic or available as Calan or Veralan, is considered as an off-label treatment for this condition.

Adverse effects of this drug include:

A newer class of medication for migraine, calcitonin gene-related peptide (CGRP) monoclonal antibodies, like Vyepti (eptinezumab) and Ajovy (fremanezumab), have shown efficacy in reducing the frequency of monthly attacks.These medications are delivered via injection. While they are Food and Drug Administration (FDA) approved, they are still a relatively new treatment and research is ongoing.

Side effects are mild and rare with CGRP monoclonal antibodies, though use may cause irritation or infection at the site of injection. In addition, injections can cause a mild allergic reaction, leading to itchiness, hives, or a rash.

Botox Injection

Though they can be effective, Botox injection treatments are needed once every three months.

When used to treat migraine, the most common side effects of this treatment are:

If migraines have already begun, it’s important to treat them as soon as possible. Earlier intervention is generally better for the overall outcome, reducing the severity of pain and duration of the attacks.

Several classes of drugs, both prescribed andover-the-counter, may be used to help ease symptoms.

Over-the-Counter (OTC) Options

Depending on the case, doctors may suggest you first try OTC pain relievers. There are many that can help, though some are designed specifically for migraine, including:

However, using these too often or too many at a time can become problematic. In some cases, it can actually make headaches worse, a condition called medication overuse headache (MOH).

Triptans

Often the first-line medications for migraine attacks,triptansbind to 5-HT receptors in brain cells, which bind to serotonin. Low levels of this hormone are associated with attacks causing blood vessels to narrow. Triptans like Imitrex (sumatriptan) and Zomig (zolmitriptan), among others, vasoconstriction (narrowing of the blood vessels) in the brain.

Available as injections, patches, or tablets, there are some side effects associated with these drugs, including:

Dopamine Antagonist Antiemetics

Generally used to take on nausea and vomiting, some dopamine antagonist antiemetic drugs may be indicated for migraine cases. Compazine (prochlorperazine), chlorpromazine, and Reglan (metoclopramide) are among the medications that may be considered.

With a solid track record in managing migraine cases, these drugs do cause some side effects. The most common of these are:

Prolonged use of these has been associated with neurological issues and effects on motor ability.

Opioids

Stronger painkilling drugs may also be used to help with headache pain. For migraines,opioid medicationslike butorphanol, codeine, and Ultram (tramadol) may be considered.This approach is not recommended for chronic migraine cases.

That said, these can be highly addictive and cause many side effects, including:

CGRP Antagonists

Serotonin Receptor Agonists

Management and Prevention of Migraines

Luckily, there are several steps you can take to help manage your condition.

Get Good Sleep

Those who often get a poor night’s rest are more likely to experience migraines at a greater frequency.

Here are some tips to improve your sleep quality:

Try Relaxation Methods

Since stress, anxiety, and physical overexertion are all reliable migraine triggers, relaxation strategies can be instrumental in preventing attacks. Your doctor may recommend you do yoga, meditation, and get regular exercise.

Get Exercise

Among the manybenefits of a good fitness regimenis that it can reduce the severity and frequency attacks. Not only does this improve the quality of sleep, but it can help get at conditions that can bring on migraines, such as obesity and sleep apnea.

At minimum, you should aim for 150 minutes of light to moderate activity (such as walking or cycling), or about 30 minutes a day, five days a week.

Other Methods

Several other means may be attempted to help with migraines. One option, biofeedback, focuses on tracking your body’s signs of stress and tension using a specialized device worn on the body. Since spikes in stress response can bring on attacks, wearers can learn to sense them coming, making them better able to manage their condition.

There is also evidence that regularacupuncturetreatment can reduce the frequency of migraine attacks.This traditional Chinese medical modality relies on the use of needles inserted into the skin at strategic spots. In turn, nerve pathways are stimulated, which may help with headaches and other symptoms.

When to Seek Professional Treatment

If you get regular and very debilitating headaches, it’s important to be proactive about getting help. According to the National Institutes of Health (NIH), make sure to call 911 and seek emergency care if:

If you’re living with migraine attacks, it’s also important to be vigilant of changes or other factors that can affect your treatment. Here’s a rundown of reasons to call your doctor or primary care provider:

A Word From Verywell

While medications shouldn’t be the only aspect of migraine management, they can play a significant role in helping you get a handle on this difficult condition. As with any medical treatment, there are some drawbacks to migraine medications and care needs to be taken.

Nonetheless, these medications help countless people handle and prevent attacks. It’s worth talking to your doctor about your migraine treatment options.

This is why some medications that take on migraine after onset, such as Imitrex (sumatriptan), are often available in inhalers.Taken in this way, migraine sufferers can expect headaches to start easing in 15 minutes compared to about 30 minutes for tablets. That said, the full effect of a dose takes about two hours.

Learn MoreMedications for Treating Migraine Headaches

The amount of time medications for migraine stay in your body can also vary a great deal. Here’s a quick breakdown:Imitrex (sumatriptan): Five hoursZomig (zolmitriptan): Three hoursChlorpromazine: 30 hours.Depakote (valaproic acid): 28–30 hours.Verelan (verapamil hydrochloride): 24 hoursTalk to your doctor about the medications you’re taking and be mindful of how well they are working.

The amount of time medications for migraine stay in your body can also vary a great deal. Here’s a quick breakdown:

Talk to your doctor about the medications you’re taking and be mindful of how well they are working.

The chief nonmedical approaches to migraine include:Tracking and avoiding triggers:Keep a log of when your headaches are striking, as well as triggers you’re discovering.Getting good sleep:Make sure you are getting enough of sleep, during regular hours, can help.Relaxation: Tension and stress need to be addressed. Relaxation techniques, such as yoga or meditation, can help.Exercise and diet:Regular fitness work can help improve the quality of sleep. Along with a healthy diet, exercise can help manage obesity and sleep apnea, which are major risk factors.Managing attacks: If migraines are striking, try to rest in a quiet and dark place. This should ease some symptoms.Consider alternatives:Acupuncture has been shown to help with the frequency of migraine attacks and can be considered along with other therapies.Learn MoreTop 10 Ways to Avoid or Reduce Headache and Migraine Pain

The chief nonmedical approaches to migraine include:Tracking and avoiding triggers:Keep a log of when your headaches are striking, as well as triggers you’re discovering.Getting good sleep:Make sure you are getting enough of sleep, during regular hours, can help.Relaxation: Tension and stress need to be addressed. Relaxation techniques, such as yoga or meditation, can help.Exercise and diet:Regular fitness work can help improve the quality of sleep. Along with a healthy diet, exercise can help manage obesity and sleep apnea, which are major risk factors.Managing attacks: If migraines are striking, try to rest in a quiet and dark place. This should ease some symptoms.Consider alternatives:Acupuncture has been shown to help with the frequency of migraine attacks and can be considered along with other therapies.

The chief nonmedical approaches to migraine include:

Learn MoreTop 10 Ways to Avoid or Reduce Headache and Migraine Pain

16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Migraine.Cleveland Clinic.Migraine headaches: causes, treatment & symptoms.Mungoven TJ, Henderson LA, Meylakh N.Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne). 2021 Aug 25;2:705276. doi: 10.3389/fpain.2021.705276Johns Hopkins Medicine.How a migraine happens.Ha H, Gonzalez A.Migraine headache prophylaxis.Am Fam Physician. 2019;99(1):17-24.National Institutes of Health.Label: Verapamil hydrochloride capsule, extended release.Ajovy (fremanezumab-vfrm) injection.Full prescribing information.US Food and Drug Administration.Highlights of prescribing information: Botox (onabotulinumtoxinA).Mayans L, Walling A.Acute migraine headache: treatment strategies.Am Fam Physician.2018 Feb 15;97(4):243-251.National Institutes of Health.Sumatriptan. MedlinePlus Drug Information.National Institutes of Health.Compazine prochlorperazine.National Institutes of Health.Prescription opioids.Beauchene JK, Levien TL.Lasmiditan: Acute Migraine Treatment Without Vasoconstriction. A Review. J Pharm Technol. 2021 Oct;37(5):244-253. doi: 10.1177/87551225211024630Lin YK, Lin GY, Lee JT, et al.Associations between sleep quality and migraine frequency: a cross-sectional case-control study.Medicine (Baltimore). 2016;95(17):e3554. doi:10.1097/MD.0000000000003554Centers for Disease Control and Prevention.Tips for Better Sleep.Linde K, Allais G, Brinkhaus B, et al.Acupuncture for the prevention of episodic migraine.Cochrane Database of Systematic Reviews. 2016;2016(6):CD001218. doi:10.1002/14651858.cd001218.pub3

16 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Migraine.Cleveland Clinic.Migraine headaches: causes, treatment & symptoms.Mungoven TJ, Henderson LA, Meylakh N.Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne). 2021 Aug 25;2:705276. doi: 10.3389/fpain.2021.705276Johns Hopkins Medicine.How a migraine happens.Ha H, Gonzalez A.Migraine headache prophylaxis.Am Fam Physician. 2019;99(1):17-24.National Institutes of Health.Label: Verapamil hydrochloride capsule, extended release.Ajovy (fremanezumab-vfrm) injection.Full prescribing information.US Food and Drug Administration.Highlights of prescribing information: Botox (onabotulinumtoxinA).Mayans L, Walling A.Acute migraine headache: treatment strategies.Am Fam Physician.2018 Feb 15;97(4):243-251.National Institutes of Health.Sumatriptan. MedlinePlus Drug Information.National Institutes of Health.Compazine prochlorperazine.National Institutes of Health.Prescription opioids.Beauchene JK, Levien TL.Lasmiditan: Acute Migraine Treatment Without Vasoconstriction. A Review. J Pharm Technol. 2021 Oct;37(5):244-253. doi: 10.1177/87551225211024630Lin YK, Lin GY, Lee JT, et al.Associations between sleep quality and migraine frequency: a cross-sectional case-control study.Medicine (Baltimore). 2016;95(17):e3554. doi:10.1097/MD.0000000000003554Centers for Disease Control and Prevention.Tips for Better Sleep.Linde K, Allais G, Brinkhaus B, et al.Acupuncture for the prevention of episodic migraine.Cochrane Database of Systematic Reviews. 2016;2016(6):CD001218. doi:10.1002/14651858.cd001218.pub3

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institutes of Health.Migraine.Cleveland Clinic.Migraine headaches: causes, treatment & symptoms.Mungoven TJ, Henderson LA, Meylakh N.Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne). 2021 Aug 25;2:705276. doi: 10.3389/fpain.2021.705276Johns Hopkins Medicine.How a migraine happens.Ha H, Gonzalez A.Migraine headache prophylaxis.Am Fam Physician. 2019;99(1):17-24.National Institutes of Health.Label: Verapamil hydrochloride capsule, extended release.Ajovy (fremanezumab-vfrm) injection.Full prescribing information.US Food and Drug Administration.Highlights of prescribing information: Botox (onabotulinumtoxinA).Mayans L, Walling A.Acute migraine headache: treatment strategies.Am Fam Physician.2018 Feb 15;97(4):243-251.National Institutes of Health.Sumatriptan. MedlinePlus Drug Information.National Institutes of Health.Compazine prochlorperazine.National Institutes of Health.Prescription opioids.Beauchene JK, Levien TL.Lasmiditan: Acute Migraine Treatment Without Vasoconstriction. A Review. J Pharm Technol. 2021 Oct;37(5):244-253. doi: 10.1177/87551225211024630Lin YK, Lin GY, Lee JT, et al.Associations between sleep quality and migraine frequency: a cross-sectional case-control study.Medicine (Baltimore). 2016;95(17):e3554. doi:10.1097/MD.0000000000003554Centers for Disease Control and Prevention.Tips for Better Sleep.Linde K, Allais G, Brinkhaus B, et al.Acupuncture for the prevention of episodic migraine.Cochrane Database of Systematic Reviews. 2016;2016(6):CD001218. doi:10.1002/14651858.cd001218.pub3

National Institutes of Health.Migraine.

Cleveland Clinic.Migraine headaches: causes, treatment & symptoms.

Mungoven TJ, Henderson LA, Meylakh N.Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne). 2021 Aug 25;2:705276. doi: 10.3389/fpain.2021.705276

Johns Hopkins Medicine.How a migraine happens.

Ha H, Gonzalez A.Migraine headache prophylaxis.Am Fam Physician. 2019;99(1):17-24.

National Institutes of Health.Label: Verapamil hydrochloride capsule, extended release.

Ajovy (fremanezumab-vfrm) injection.Full prescribing information.

US Food and Drug Administration.Highlights of prescribing information: Botox (onabotulinumtoxinA).

Mayans L, Walling A.Acute migraine headache: treatment strategies.Am Fam Physician.2018 Feb 15;97(4):243-251.

National Institutes of Health.Sumatriptan. MedlinePlus Drug Information.

National Institutes of Health.Compazine prochlorperazine.

National Institutes of Health.Prescription opioids.

Beauchene JK, Levien TL.Lasmiditan: Acute Migraine Treatment Without Vasoconstriction. A Review. J Pharm Technol. 2021 Oct;37(5):244-253. doi: 10.1177/87551225211024630

Lin YK, Lin GY, Lee JT, et al.Associations between sleep quality and migraine frequency: a cross-sectional case-control study.Medicine (Baltimore). 2016;95(17):e3554. doi:10.1097/MD.0000000000003554

Centers for Disease Control and Prevention.Tips for Better Sleep.

Linde K, Allais G, Brinkhaus B, et al.Acupuncture for the prevention of episodic migraine.Cochrane Database of Systematic Reviews. 2016;2016(6):CD001218. doi:10.1002/14651858.cd001218.pub3

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?