Drugs that stop migraine pain, prevent attacks

By Hida Nierenburg, MD  |  6/27/2019

You may need a prevention medication, which is used to decrease the frequency, severity and duration of your attacks. You may also need a rescue medication that helps eliminate pain more rapidly, usually within two hours.

Prevention strategies

You fall into the first category if you have frequent migraines (more than four per month). Until last year, there was not a migraine-specific preventive medication. Beta blockers, antidepressants, calcium channel blockers, anticonvulsants and other medications were generally prescribed. Botox is FDA approved as preventive medication for chronic migraine. Or, people could turn to Botox injections. It's believed Botox freezes the nerve endings thought to cause pain.

Last year the first class of preventive medication were FDA approved. These are called CGRP receptor antagonists. These drug targets the receptor for a protein released in nerve endings throughout the body thought to transmit pain and cause inflammation.  So far there have been 3 medications approved by the FDA called erenumab, galcanezumab and fremanezumab.  So far these have been an exciting development in migraine preventive treatment and a significant advancement for migraine treatment.

Pain relief strategies

For fast-acting pain relief, some mild to moderate painkillers used include aspirin, naproxen, ibuprofen or diclofenac. For others, a triptan drug is the first-line treatment for pain relief and is safe to use as long as the patient has no health risks such as heart disease, diabetes or high cholesterol. There are eight different types of triptans and the response and side effects vary from patient to patient. Speak to a physician to learn more.

If you do use a rescue drug, remember to take it early and use it properly. Overtreatment can lead to medication overuse headaches. For example, if you find yourself reaching for aspirin or ibuprofen more than 15 days per month, visit a physician to discuss whether these medications are right for you.

Read about how a migraine is diagnosed.

Dr. Hida Nierenburg see patients at Health Quest Medical Practice's Kingston neurology office and focuses on the treatment of headaches and general neurologic conditions. Read more about Dr. Nierenburg or call 845-331-5165 (TTY: 800-421-1220) for an appointment.