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What is the Best Migraine Medication?

What Is a Migraine?

A migraine is a strong headache that often comes with nausea, vomiting, and sensitivity to light. It can last hours or days.

Migraine Symptoms

Migraines are different in everyone. In many people, they happen in stages. These stages may include:

Prodrome

Hours or days before a headache, about 60% of people who have migraines notice symptoms like:

  • Being sensitive to light, sound, or smell
  • Fatigue
  • Food cravings or lack of appetite
  • Mood changes
  • Severe thirst
  • Bloating
  • Constipation or diarrhea

Aura

These symptoms stem from your nervous system and often involve your vision. They usually start gradually, over a 5- to 20-minute period, and last less than an hour. You may:

  • See black dots, wavy lines, flashes of light, or things that aren’t there (hallucinations)
  • Have tunnel vision
  • Not be able to see at all
  • Have tingling or numbness on one side of your body
  • Not be able to speak clearly
  • Have a heavy feeling in your arms and legs
  • Have ringing in your ears
  • Notice changes in smell, taste, or touch

Medical Treatment

Drugs for migraine headaches can relieve the pain and symptoms of a migraine attack and help prevent further migraine attacks.

Migraines can be treated with two types of drugs: abortive and preventive.

Abortive: The goal of abortive treatment is to stop a migraine once it starts. Abortive medications stop a migraine when you feel one coming or once it has begun. Abortive medications can be taken by self-injection, mouth, skin patch, or nasal spray. These forms of medication are especially useful for people who have nausea or vomiting related to their migraine, and they work quickly.

Abortive treatments include the triptans and ditans, which specifically target serotonin. They are all very similar in their action and chemical structure. The triptans are used only to treat headache and do not relieve pain from back problems, arthritis, menstruation, or other conditions. People with certain medical conditions should not take these medications.

  • Almotriptan (Axert)
  • Eletriptan (Relpax)
  • Frovatriptan (Frova)
  • Naratriptan (Amerge)
  • Rizatriptan (Maxalt)
  • Sumatriptan ( Alsuma, Imitrex, Onzetra, Sumavel, Zembrace)
  • Zolmitriptan (Zomig)

The following drugs are also used for treatment:

  • OTC pain meds and combination pain meds including: Advil Migraine (containing ibuprofen), Excedrin Migraine (containing aspirin, acetaminophen , caffeine), isometheptene-dichloralphenazone-acetaminophen (Midrin),and Motrin Migraine Pain (containing ibuprofen)
  • Ergots including: Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray),Ergotamine tartrate (Cafergot)
  • CGRP antagonists – rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy)

The following drugs are sometimes used for nausea related to migraine headaches, in addition to migraine treatment:

  • Chlorpromazine (Thorazine)
  • Droperidol
  • Metoclopramide (Reglan)
  • Prochlorperazine (Compro,)

Some drugs are used for headache pain, but are not specific for migraines. These include analgesics, narcotics, and barbiturates. Since some of these can be habit forming, they are less desirable than specific headache drugs listed above. These drugs should be used primarily as a “backup” for the occasions when a specific drug does not work.

Preventive: This type of treatment is considered if migraines occur frequently, typically more than one migraine per week, or if migraine symptoms are severe. The goal is to lessen the frequency and severity of the migraine attacks. Medication to prevent a migraine can be taken daily. Preventive treatment medications include the following:

  • Medications used to treat high blood pressure:
    • beta-blockers (propranolol, timolol, metoprolol)
    • calcium channel blockers (verapamil)
  • Antidepressants: amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor)
  • Antiseizure medications: gabapentin (Neurontin), topiramate (Topamax), valproic acid (Depakote)
  • CGRP inhibitors used to block the calcitonin gene-related peptide: atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality)
  • Botox
Some nontraditional supplement treatments for migraine prevention include certified PA-free butterbur, coenzyme Q10, and feverfew. Whether they really help isn’t known, because studies have shown mixed results. Check with your doctor before using any supplements as they are not regulated like prescription medicines and they may contain substances that are not safe.If you can’t take medication or wish not to, a device might be worth considering. These include:

  • Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
  • Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.
  • Noninvasive vagus nerve stimulator (nVS) gammaCore is a hand-held portable device placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
  • Nerivio, a wireless remote electrical neuromodulation device that is self-applied to the upper-arm and should be used in the home environment at the onset of migraine headache..

i have had migraines off and on for years, due to a car accident. The last 2 years, the migraines have cropped up more often and my physician will prescribe a headache med for me to have on hand. The problem is, she says that they are all very similar.

So , the question for yahoo users will be, in your personal migraine encounters, what prescription migraine medicine worked best, and were there side effects, etc?

Thanks!

There are maybe a lot of solutions for this question. But I think the best answer is:

Answer simply by IndyMom

I have had migraines for 30 years. None are the best. The question is in finding the best one for you. You are the only one who can determine that will. Ask the Doc. in order to prescribe the migraine contraceptive medications one at a time until you find the one that works best for you.

I personally use Imitrex. I have also attempted Maxalt,  Zomig and all of the others that I don’t remember the names of.  Imitrex has been the best for me.

The key with any of these is to take them immediately, as soon as you realize that the pain is arriving or expect that it is heading to migraine level. If you wait around until you have a full taken migraine, no medication will work.

Keep a daily headache journal when you try the new medications. At the end of a few days, or several weeks depending on how often you get them, you will have the details for the Doctor. Help them to help you.

Best of luck.

include your own answer in the feedback!

4 Comments

  1. Tracey!

    I have suffered with migraines since I was 14, I am now 39. Last year I was prescribed Lyrica for postherpetic neuralgia after a nasty bout of shingles. Since then I have had hardly any migraines at all and definately nowhere near as severe. When i asked my pain consultant about this he said others had said the same thing but it wasn’t usually prescribed for migraine. It is actually an anti epilepsy drug and my understanding is that it works by changing the nerve pattern.
    It is a med that you gradually build up the dosage, the side effects are pretty extreme to start off with but they have settled now. The only way I can describe the side effects is that feeling when you have drunk wayyyyyyyyy to much, the room is spinning, the floor seems to move when you walk, you try to lay down but the bed moves and feel very nauseous! For me the benefits now made the side effects worth while to begin with!
    I had tried pretty much every migraine drug available before all to no avail and my migraines would put me in bed for 2 to 3 days at a time.

  2. FishStory

    I tried daily meds – the anit seizures and the anti-anxiety ones, but they didn’t really help and the side effects made me crazy – dry mouth, dizziness, memory loss, tiredness… yuck.
    These were Topomax, Neurontin, Propranolol, wellbutrin,

    Imitrex did nothing. Axert usually works, and Maxalt is slightly less effective for me than Axert.

  3. Brandi C

    I get frequent, severe migraines. I have tried numerous different ones and while they are similar I find that Imitrex works the best, I use the higher dose (although I can’t remember what that is at the moment). I take 1 Imitrex and 1 over the counter Excedrin Migraine at the same time and that really kicks it in the butt. I asked my Dr. if it was okay to take them together and she said yes.

  4. June

    I’ve had Migraines since childhood and I get them less as I get older. I’m sure the answer is different for everyone, but for me it’s Advil Migraine. (I know they say it’s the same thing as regular Advil but this is just what works for me.) I’ve tried other meds over the years. Many people say Imitrex works good, although it made my heart race and it didn’t work for me. I also took an ergot based medication years ago and it made me ill, although the headache went away. Good luck!

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