What You Need to Know About Chronic Migraines Medication
March 16, 2023Living with chronic migraines can be debilitating. While there is no cure for chronic migraines, medication is often prescribed to help alleviate the pain associated with them. Read on to learn more about the different types of chronic migraines medication and what might be prescribed to you.
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As people who have experienced these before, a migraine is not just a headache. It’s a potentially disabling neurological condition that often causes debilitating symptoms. These include severe pain, nausea and the inability to tolerate sounds, light and certain smells.
There are many kinds of migraine, from vestibular migraine that causes balance problems to status migrainosus that causes pain and nausea so severe that sufferers are often hospitalized. Medical experts further categorize migraines according to frequency.
Some people only get migraines once in a while, and others experience migraines eight to 14 days each month. However, those with chronic migraines have migraine headaches 15 days or more a month.
While chronic migraines don’t have a cure, there are medications available that can help make symptoms more manageable and prevent future attacks. How do you know which one is the best medicine for chronic migraines? What do doctors consider when prescribing chronic migraines medication?
We’ll explore the answers to these questions in the sections below.
Commonly Prescribed Chronic Migraines Medication
Many people with chronic migraines resort to over-the-counter medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), for relief. However, these don’t always provide relief. In this case, doctors may need to prescribe stronger medication.
Migraine medications can be used in different forms, such as capsules, nasal sprays, lozenges, tablets, suppositories and injections. They can be broadly categorized into abortive and preventative. Depending on the type and frequency of your migraines, you might need one or more kinds of chronic migraine medication.
Prescription Medication for Acute Treatment
Also referred to as abortive medication, this medication is meant to be taken at the first sign of a migraine or during an aura. Your doctor might instruct you to take it only as needed. If you have to use it more than nine times a month, you’ll likely need preventative medication as well.
Medications for acute treatment of migraine include the following.
Pain Relievers
Pain is a common symptom of migraine. For relief, you may use over-the-counter medication. However, your doctor may prescribe stronger pain-relief drugs if pain is too intense.
The following are some examples of pain relievers. | Generic Name | Examples of Brand Names | |:---------------------------------: |:-----------------------------------------------------------------------------------------: | | Ibuprofen | Advil®, Midol®, Motrin® | | Acetaminophen | Tylenol®, Feverall®, Panadol® | | Naproxen | Aleve®, Flanax® | | Aspirin/ Acetylsalicylic acid | Bufferin®, Anacin® Aspirin Regimen | | Diclofenac | Cambia®, Zorvolex® |
Anti-Nausea Medication
Nausea and vomiting are common symptoms of migraine attacks. To address these, doctors may prescribe anti-nausea medication such as the following:
| Generic Name | Examples of Brand Names |
|---|---|
| Promethazine hydrochloride* | |
| Metoclopramide hydrochloride | Reglan® |
| Prochlorperazine | Compro®, Procomp® |
| Trimethobenzamide | Tigan® |
| Chlorpromazine* |
*Generic only
Ergot Alkaloids
Also called “ergots,” ergot alkaloids are among the first medications specifically meant to treat migraines.
When blood vessels in the brain are dilated or widened, they can result in migraine headaches. Ergots work by narrowing these blood vessels, thus relieving pain. Some examples of ergots are as follows:
| Generic Name | Examples of Brand Names |
|---|---|
| Ergotamine and caffeine | Cafergot®, Migergot |
| Methylergonovine | Methergine® |
| Dihydroergotamine mesylate | Migranal®, Trudhesa® |
Triptans
This class of drug works similarly to ergot alkaloids. They constrict blood vessels and reduce inflammation to help stop migraine symptoms or reduce their severity. Examples of triptans include the following:
| Generic Name | Examples of Brand Names |
|---|---|
| Rizatriptan | Maxalt® |
| Sumatriptan | Imitrex® Tablets |
| Eletriptan | Relpax® |
| Naratriptan | Amerge® |
| Almotriptan | Axert® |
| Zolmitriptan | Zomig®, Zomig-ZMT® |
| Frovatriptan | Frova® |
Opioids
A doctor may prescribe opioids if other chronic migraines medication do not help with symptoms. They work by triggering the release of endorphins, hormones that relieve pain. However, opioids are highly addictive, so they’re usually only prescribed to be taken for short periods.
Examples of opioids include:
| Generic Name | Brand Name/s |
|---|---|
| Morphine | Morphabond®, Kadian® |
| Codeine | Fioricet® with Codeine® (with butalbital, acetaminophen and caffeine), Ascomp® with Codeine (with butalbital, aspirin and caffeine) |
| Oxycodone | Oxaydo® |
| Hydrocodone | Hysingla®, Zohydro ER® |
Preventative Medication for Chronic Migraine
Preventative chronic migraines medication can be prescribed to help prevent future migraine attacks in people with chronic migraine and gradually reduce the severity of symptoms. This type of prescription medication is typically taken daily.
Unlike medications for acute treatment, preventative migraine medicines do not provide quick relief from symptoms. You might have to wait weeks or months to experience the benefits. The following are some types of medications used to help prevent migraines:
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How Doctors Prescribe the Best Medicine for Chronic Migraines
Patients can empower themselves to make informed choices on their treatment by learning more about commonly prescribed chronic migraines medication. Additionally, it helps to know the factors doctors consider when deciding on the best medicine for chronic migraines to prescribe to you. These include:
- Your current health condition
- The type of migraine you have
- The severity and frequency of your migraine attacks
- Allergies or intolerance to certain medications
- The effectiveness of the drug, as gauged via studies and outcomes of other patients
- Possible side-effects
During a doctor’s visit is the ideal time to ask any questions you may have about your medication. Your physician may factor in your personal preferences when prescribing medication. For instance, if you foresee that you will have difficulty affording long-term medication for chronic migraines, you may ask your doctor if they could prescribe the generic version of the drug.
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Sources:
- https://www.webmd.com/migraines-headaches/ergot-alkaloids-migraine
- https://migraine.com/migraine-treatment/ergotamine
- https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults
- https://touchneurology.com/headache-disorders/journal-articles/rational-prescribing-for-migraine-prevention/
- https://www.ncbi.nlm.nih.gov/books/NBK507873/
- https://www.webmd.com/migraines-headaches/migraine-treatment#091e9c5e800125dd-2-3
- https://americanmigrainefoundation.org/resource-library/what-is-migraine/