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Migraine Treatment Overview

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Care Plan


First steps to consider

  • You can treat occasional migraines with at-home care.
  • Try OTC pain medications or prescription migraine medications that have been prescribed for you.
  • Avoid known triggers and try to rest.

When you may need a provider

  • Migraines occur more than about 8 days a month, or they interfere with your quality of life.
  • You have bad headaches but have never been diagnosed.
  • Your migraine medications aren’t helping or a migraine lasts more than about 3 days.

Emergency Care

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Go to the ER or call 911 if you have any of the following symptoms:

  • Worst headache of your life
  • Fever
  • Neck stiffness
  • Confusion
  • Recent head injury
  • More than one episode of vomiting
  • Loss of vision

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All treatments for migraine
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Read more about migraine care options

When to see a healthcare provider

If you think you have migraine headaches but have never been diagnosed, consider seeing a healthcare provider. Some headaches may be caused by other conditions like eye strain, sinus problems, high blood pressure, or, rarely, more serious issues like a brain tumor. A doctor can help you get an accurate diagnosis.

Also see a doctor if you have a migraine that doesn’t get better after 3 days of home care, or if you have chronic migraines (more than about 8–10 days per month) or if your migraines interfere with your regular activities (including school or work).

Your doctor may refer you to a neurologist or pain doctor who specializes in migraines. They will be able to help you figure out medical and lifestyle treatments that can help reduce the frequency and severity of your migraines.

If you have had migraines in the past but develop a new headache that is somehow different—more severe, more frequent, longer lasting, doesn’t respond to usual treatments—check in with your doctor. Any new severe headache should be evaluated by a doctor.

Getting diagnosed

Migraines are diagnosed based on your symptoms. Sometimes additional tests are needed to check for more serious causes of your headache. This may include a CT scan or MRI. Blood tests could help detect inflammation or infection.

What to expect from your doctor visit

Your doctor can help you create a treatment plan that includes medications and lifestyle changes. If your migraines are occasional, your doctor will recommend OTC and prescription medications to take at the first sign of a migraine (these are called rescue medications).

If your migraines are more frequent, occurring about 10 or more days a month, your doctor may recommend medications you take preventively to reduce the frequency and intensity of the migraines. These include some antidepressants, anti-seizure medications, and a new class of medications called CGRP blockers. You may need to try a few medications before you find the one that’s right for you.

Prescription medications to take during a migraine

  • Triptans or ditans to stop (abort) a current headache
    • Sumatriptan (Imitrex)
    • Rizatriptan (Maxalt)
    • Lasmiditan (Reyvow)
  • Anti-nausea medications, including:
    • Metoclopramide (Reglan)
    • Ondansetron (Zofran)
  • Selective serotonin reuptake inhibitor (SSRI)
    • Lasmiditan (Reyvow)
  • Calcitonin gene-related peptide blocker for treatment
    • Ubrogepant (Ubrelvy)

Prescription medications to help prevent migraines

  • Some antidepressants
    • Amitriptyline (Elavil)
  • Anti-seizure medications
    • Valproic acid (Depakote)
    • Topiramate (Topamax)
  • Blood pressure medications called beta blockers
    • Propranolol (Inderal)
    • Metoprolol (Toprol XL)
    • Timolol (Blocadren)
  • Calcitonin gene-related peptide (CGRP) blockers are a newer class of medication used to migraines
    • Some CGRP blockers are given by self-injection, usually at home
      • Erenumab (Aimovig)
      • Fremanezumab (Ajovy)
      • Galcanezumab (Emgality)
      • Eptinezumab (Vyepti) is given by IV, usually at a clinic
    • Rimegepant (Nurtec ODT) for prevention as well as acute treatment

Your doctor will also discuss evidence-based recommendations that may help reduce how often you get migraines. It may include:

  • Improving your sleep habits
  • Diet changes
  • Exercise
  • Discussing possible triggers to avoid

Other treatments your doctor may consider include Botox injections in your head and magnetic or electrical nerve stimulation.

  • Botox: A doctor injects Botox into multiple trigger points in the head or neck to block the neurotransmitters that send pain signals to your brain. The injections can be painful.
  • Electrical nerve stimulation: A device that sends an electrical signal to stimulate your nerves, interrupting pain pathways related to migraine, is placed on your forehead or neck. You may feel a tingling sensation, but it should not be painful.

Types of migraine providers

  • A primary care physician for mild or moderate migraines that don’t respond to home treatment after about 3 days
  • A neurologist is a doctor specializing in brain and nerve conditions. They often are trained in treating migraines.
  • Pain specialist, a doctor who focuses on pain conditions including migraines
  • An emergency medicine physician (ER doctor), if you have a severe or unusual headache that needs to be evaluated right away.
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