Treatment options for migraine are largely grouped into acute medications, preventative medications, symptom management, and alternative therapies.
- Ditans (not yet available) work like triptans but can be used by people with heart conditions. The first one, Reyvow, has just been released in the United States.
- Gepants (not yet available) are CGRP antagonists. Read more on the CGRP page.
- CGRP Treatments
- Beta-blockers are blood pressure medication, the most commonly prescribed is Inderal.
- Anti-epileptic medications more commonly used in epilepsy, such as Topamax.
- Anti-depressants such as amitriptyline.
The Migraine Trust also has a particularly good page on preventative options.
Most people with migraine will manage their attacks symptomatically – that is, they will treat the headache or nausea, rather than using migraine specific medications. This includes:
- Over the counter medications like paracetamol or aspirin
- Prescription medications to manage pain, like codeine and tramadol, or Antiemetic (anti-nausea) medication, such as Ondansetron, Stemitil or Maxalon.
- Medicinal cannabis has been shown to have some benefit for some people in the small limited studies so far, but can be difficult to get.
There are a range of things you can do to help prevent and manage migraine attacks that do not involve drugs. This includes:
- Trigger avoidance
- Sticking to a routine
Allied health professionals can provide a great deal of assistance in managing migraine. The main ones used by many migraine patients are:
Others will find relief working with an exercise physiologist, chiropractor, nutritionist, occupational therapist, or osteopath. As migraine is a complex condition that every experience differently, you need to find the right combination of therapies that work for you.
BEWARE THE ‘CURES’
We have not had effective preventative treatment for migraine prior to the introduction of the CGRPs, triptans don’t work for everyone, and there is an enormous number of people living with migraine. Because of this trifecta, we are a vulnerable target for aggressive marketers promoting devices, protocols, systems, diets and concoctions promising a miracle cure. Migraine cannot be cured.
We all have moments of desperation when we are willing to try anything for some relief. Try to protect yourself by never making the decision to do or try anything without discussing it with your doctor first, and don’t buy things when severely affected by a migraine attack.