Migraine headaches can cause pulsating or throbbing pain on one or both sides of the head. Abortive migraine medication can treat symptoms when a person experiences a migraine headache.

There are two treatments for migraine headache: abortive and preventive care. Abortive care often involves medications to help treat a migraine headache and symptoms as it occurs. Preventive care helps stop migraine headaches from happening.

While abortive migraine medication can help soothe symptoms, people may experience side effects. Keep reading for more information on medications that treat migraine headaches, their benefits, side effects, and more.

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Abortive migraine medications are drugs that can help stop a migraine headache after it starts.

The National Institute of Neurological Disorders and Stroke states that approximately 12% of people living in the United States experience migraine headaches.

Research notes that over half of all people who have migraine headaches use over-the-counter pain relievers and only contact a doctor when nonprescription medication does not work or stops working.

For mild to moderate migraine headaches, a doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) as the first line of therapy.

However, for severe migraine headaches or those that do not respond to nonprescription medications, a doctor may prescribe triptans or ergotamines as abortive care.

Triptans are a type of medication that doctors may prescribe for migraine headaches with or without aura. This medication works by selectively binding to the serotonin receptors 5-HT1B and 5-HT1D, reducing inflammation and blocking the pain receptors in the brain.

Ergotamine also targets 5HT-1 serotonin receptors. Unlike triptans, they are non-selective. Due to potential side effects and newer medications, doctors typically prescribe this medication as a secondary line of treatment when triptans or other treatments do not work.

Doctors are likely to recommend over-the-counter (OTC) pain relief medication or triptans as the first line of treatment if a person has mild or moderate migraine headaches.

If a person’s migraine headache does not respond to nonprescription medication or a person’s migraine headache is severe, a doctor may prescribe triptans or ergotamines.

However, doctors will not prescribe triptans and ergotamines to everyone with migraine. Most triptans are unsuitable for those who are pregnant or breastfeeding. Doctors will not prescribe any triptans for people who are over 65 years old or who have:

A 2013 research paper notes that the American Academy of Pediatrics (AAP) considers sumatriptan a compatible medication while breastfeeding.

The researchers also suggest that eletriptan is also safe for use in people who are breastfeeding. However, the AAP has not reviewed eletriptan for this use.

People who cannot use triptans will not be able to use ergotamines. In addition, doctors will not prescribe this medication for people who take CYP 3A4 inhibitors as it can result in stroke, gangrene, or death. These inhibitors include:

A doctor will work with a person to determine the best treatment plan for their needs.

Triptans are a class of medication that treat migraine headache symptoms. Currently, doctors can prescribe seven different triptan medications, including:

  • sumatriptan, which is also suitable for cluster headaches
  • naratriptan and frovatriptan, which doctors may prescribe off-label for menstrual migraine headaches
  • zolmitriptan, which is available in a nasal spray for children ages 12 years or over
  • almotriptan, which is suitable for teenagers with migraine headaches lasting more than 4 hours

People can take triptans as soon as a migraine headache starts and take them once every 2 hours. However, triptans are not effective if a person takes the medication during the aura phase before the headache develops.

Efficacy

Triptans are an effective treatment for migraine headaches. A 2015 study found that triptans relieved migraine headaches for 42–76% of participants within 2 hours and prevented pain for another 2 hours in 18–50% of participants.

The study notes that triptans were more effective than ergotamines and equally or more effective than NSAIDs, acetaminophen, and acetylsalicylic acid (ASA). Participants reported less pain and prolonged pain relief with a combination of triptans and acetaminophen or ASA.

The researchers also found that sumatriptan injections and oral zolmitriptan, rizatriptan, and eletriptan treated migraine headaches more effectively than other triptan medications.

Side effects

Triptans can cause side effects. Taking triptans for more than 10 days a month can lead to triptan overuse headache. Other potential side effects can include:

Less than 1% of people may experience irregular heartbeat, heart attack, or stroke.

Ergotamines are a type of ergot alkaloid class medication. Doctors may prescribe this medication when OTC drugs, triptans, or other medications, do not ease symptoms.

Ergotamines are available in tablet, suppository, injection, and aerosol form. A person may take the medication at the first sign of a migraine headache and take another tablet in 30-minute intervals if necessary.

Efficacy

Ergotamines are effective at treating migraine headaches, especially when combined with caffeine. Research shows that dissolving tablets under the tongue can treat slow onset migraine headaches, while a suppository may be best for a person with a rapid onset headache.

A 2018 study found that ergotamine combined with caffeine, camylofin, mecloxamine, and the painkiller propyphenazone is more effective than sumatriptan in treating migraine headaches without an aura.

The researchers also found that while triptans are more effective at reducing pain, ergotamine is more effective for migraine headaches that have a longer duration and for people who experience more frequent headaches.

Side effects

Ergotamines can cause a range of side effects. The most common include:

Doctors will not prescribe triptans or ergotamines if a person is pregnant or breastfeeding, over 65 years old, or has specific health conditions. These medications can cause raised blood pressure, which can be dangerous if a person has high blood pressure or a history of heart attacks.

Triptan overdose has a low risk of death. Signs of triptan overdose include high blood pressure, rapid heart rate, and drowsiness.

People who overdose on ergotamines are at risk of ergotamine poisoning, which can result in death. Symptoms of overdose include:

People should seek immediate medical attention if they or someone they know has taken an overdose of triptans or ergotamines.

A person should follow all instructions from their doctor and medication labels when using abortive migraine headache medication. A person should not stop therapy unless their doctor recommends they do so.

Using triptans and ergotamines can lead to overuse headaches. Stopping the use of these medications is the most effective way of treating this symptom. However, a person who stops using triptans and ergotamines may experience:

  • a worsening of headache symptoms
  • nausea
  • restlessness
  • interrupted sleep
  • diarrhea

People should discuss stopping medication with their doctor. The doctor can form a treatment plan for any withdrawal symptoms, such as prescribing antinausea medication.

The Food and Drug Administration (FDA) has approved two additional abortive migraine headache medications: Reyvow (lasmiditan) and Ubrelvy (ubrogepant).

Reyvow can reduce symptom pain within 2 hours. People should not take this medication if they intend to drive or operate heavy machinery. The medication cause side effects, including:

  • dizziness
  • fatigue
  • burning or prickling sensation in the skin

Ubrelvy can also reduce symptom severity within 2 hours. People should not take this medication in conjunction with other CYP 3A4 inhibitors, and it can cause the following side effects:

A person should talk to their doctor if they experience side effects of any medication or if the medication does not ease the migraine headaches. A doctor will work with a person to form a treatment plan to prevent and treat migraine headaches.

A person should seek immediate medical attention if they or someone they know takes an overdose of triptans or ergotamines.

People take abortive medication as soon as a migraine headache starts. The medication can reduce pain as well as other migraine headache symptoms.

A doctor may recommend NSAIDs for mild to moderate headaches, triptans for moderate to severe headaches, and ergotamines where other treatments are not working.

Each medication can cause side effects. A person should consult their doctor if they experience any side effects and seek immediate medical attention if they or someone they know takes an overdose of triptans or ergotamines.