An Overview of Migraine Treatment Options

What's In This Article?

When someone struggles with migraines, they may wonder what migraine treatment options are available. There are a wide variety of migraine treatments available. It can take time and some experimentation to find the treatment plan that works best for your needs. The following is an overview of some of the key things to know about diagnosis and migraine treatment.

How Are Migraines Diagnosed?

First, before you can receive certain treatments such as prescription medications, you have to receive a diagnosis. A neurologist will likely be the health care provider to make such a diagnosis.

Migraines are diagnosed by looking at a person’s personal and family medical history and their symptoms. Making a migraine diagnosis will also include a full neurological exam as well as a physical exam.

Depending on the circumstances, a doctor might also recommend more in-depth or specialized tests to ensure your headaches aren’t caused by an underlying medical issue.

Some of the specialized tests that might be done during the diagnosis process include:

Blood tests to look for toxins or infections in the brain or spine
Magnetic resonance imaging (MRI) which can look at the brain and blood vessels in a detailed way to ensure there aren’t nervous system or brain conditions causing the migraines
Computerized tomography (CT) scans which are a set of X-rays that create detailed images of the brain and can spot things like tumors and brain bleeds
Spinal taps which are done if a doctor suspects you may have an infection that could be causing severe headaches

Migraine Treatment Options

Once a diagnosis is made, a doctor can work with you on a treatment plan. The goal of migraine treatment is typically to help symptoms once a headache begins, but also to prevent migraines or reduce the frequency of attacks. Medications for migraines can fall into one of these two categories. They can either be pain relievers or preventative medicines. Your health care provider may recommend both.

Pain Relievers For Migraines

The first migraine treatment option is pain relievers. Pain relievers are available over-the-counter and by prescription and they work in different ways. Some of the pain relievers commonly used as a migraine treatment include:

Over-the-counter medicines: Over-the-counter migraine treatments can include aspirin, ibuprofen and acetaminophen. These OTC pain medications can relieve symptoms of mild migraines, but they may not help with more severe migraines. OTC medicines can also cause more frequent rebound migraines.
Triptans: These are a type of migraine treatment that can block pain pathways in the brain. Triptans also restrict blood vessels. They are used to relieve the pain of migraines, and they come in different forms including injections, nasal sprays and pills. Some of the commonly prescribed brand names of triptans include Imitrex, Maxalt, and Axert among others.
Ergots: These are combination medications that include ergotamine and caffeine. They tend to be less effective at treating migraines than triptans.
Opioids: The use of opioids for migraine pain is fairly controversial at this point since opioids are narcotics and are highly addictive. Sometimes an opioid like codeine might be used, but typically only if other treatments don’t work or you can’t take them for some reason.

Along with medications for the actual pain associated with migraines, other medicines may be used to treat additional symptoms. For example, anti-nausea medication may be prescribed or recommended.

Preventative Migraine Treatments

Some people are candidates to use preventative medications for migraines. People that might use preventative medications may:

Have migraine attacks lasting in excess of 12 hours
Not have relief from pain medications
Have four or more debilitating migraine attacks a month
Have auras as warning signs or other warning signs like numbness or weakness

When someone uses preventative migraine medicines, it can reduce how often they experience attacks and the severity and length of the attacks experienced.

Preventative migraine treatment options can be taken daily or as-needed if someone feels the symptoms of a pending attack.

Medications used as preventative migraine treatment include:

Antidepressants: Tricyclic antidepressants are a class of medications sometimes used as a preventative treatment for migraines. Antidepressants can impact the level of certain brain chemicals and may reduce migraine attacks or symptoms. Currently, only one tricyclic antidepressant is approved to prevent migraines and that’s amitriptyline.
Cardiovascular medications: Beta blockers are most often used to treat cardiovascular symptoms and conditions such as high blood pressure, but they can help with migraine frequency and severity as well. Propranolol is one beta blocker used as a migraine preventative medication. Also used are timolol and metoprolol tartrate.
Anti-seizure medications: Less commonly some anti-seizure medications can be given to patients to help prevent migraines. Topiramate is an example of an anti-seizure drug that may reduce the frequency of migraines, however, it can have serious side effects as well.
Botox: Botox, which is most often thought of in terms of cosmetic medicine, may help treat chronic migraines. It’s injected into the forehead and neck muscles to help with migraines, but it has to be repeated every three months.

Alternative and holistic treatments may yield some success in terms of helping with migraines. There are a wide variety of holistic migraine treatment options available, and many people opt to use them along with medications and traditional guidance from a health care provider to improve the results.

If you are going to be visiting a doctor about your migraines, there are certain things you can do ahead of time to prepare for the appointment.

First, start keeping a headache diary well in advance of your appointment if possible. You should write down your symptoms, any medications including vitamins and supplements you’re taking, and note any major life events that could be happening.

It can also be a good idea to take a family member or friend with you, to help you remember everything that’s said in your appointment. In your headache diary, when you think of questions for the doctor, write them down so you don’t forget during the day of your appointment.