There are many types of medications for people with migraine headaches. Some help to reduce symptoms, while others prevent episodes from occurring. Taking any drug can have side effects, but some are safer than others.

Over-the-counter (OTC) pain relief medication may be enough to help some people manage symptoms. For more severe or recurrent migraine headaches, a doctor may prescribe medication.

Read on to learn more about the different types of migraine headache medications and their possible risks.

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There are several OTC medications for migraine headaches that do not require a prescription from a doctor.

Analgesic medications may help to reduce pain. Examples include acetaminophen, aspirin, and ibuprofen.

Many of these analgesic medications are nonsteroidal anti-inflammatory drugs (NSAIDs). This means they also reduce inflammation, which may help with symptoms.

It is best to take these medications when the first signs of an episode occur. They will take time to enter the bloodstream, and taking them as the headache worsens may mean that the person experiences pain for longer.

When OTC medications do not work, a doctor may recommend stronger prescription drugs. There are several different types, including:

Triptans

Triptans act on the symptoms of a migraine headache in its early stages. They will not stop the migraine headache, but they can help with symptoms such as:

  • nausea
  • pain
  • light sensitivity

According to the National Headache Foundation, the Food and Drug Administration (FDA) approved triptans to treat moderate to severe migraine where the symptoms interfere with the ability to perform daily tasks.

Triptan medications include:

  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)
  • rizatriptan (Maxalt)

It is important to take these drugs as soon as migraine symptoms start. They may not work if a person takes them during a migraine aura. Depending on the type the person takes, they are available as:

  • pills
  • orally disintegrating tablets
  • nasal sprays
  • injections

Triptans may not be suitable for everybody, such as those with a history of coronary artery disease or other heart conditions. They are unsuitable for people taking ergot alkaloids and monoamine oxidase inhibitors.

Ergot alkaloids

The American Migraine Foundation points out that while doctors do not commonly prescribe ergot alkaloids, a doctor may recommend them if someone does not respond to other analgesics.

The two main types of ergot alkaloids are dihydroergotamine (DHE) and ergotamine (Ergomar). They can help to treat symptoms in severe cases where other drugs have not worked. DHE is available as an injection or infusion.

However, ergot alkaloids may cause blood vessels to narrow, which can have serious side effects. They may also interact with other medications, so it is important to inform a doctor about any other medications a person is taking.

Anti-nausea medications

Anti-nausea medications, also known as antiemetic drugs, can help people with migraine headaches, even if they do not feel nauseous. Antiemetics do not reduce pain, so some people take them alongside pain relief medication.

Examples of anti-nausea drugs include:

  • chlorpromazine (Thorazine)
  • metoclopramide (Reglan)
  • prochlorperazine (Compazine)
  • promethazine (Phenergan)

CGRP receptor antagonists

The FDA has approved several drugs that block calcitonin gene-related peptide (CGRP) receptors. CGRP is a molecule typically involved in migraine episodes.

Examples of recently approved CGRP receptor antagonists include rimegepant (NURTEC) and ubrogepant (Ubrelvy). The FDA has approved both of these drugs for the immediate treatment of migraine.

Doctors may recommend onabotulinumtoxinA (Botox) for people with chronic migraine headaches. According to a 2018 article, a doctor might prescribe Botox if a person has experienced at least 15 headaches per month for 3 months, with at least eight of these headaches including migraine symptoms.

Botox comes as an injection and can have many side effects. Doctors monitor progress carefully.

A person may require injections every 12 weeks. Doctors may also stop treatment if migraine episodes reduce for at least 3 months.

It is better to avoid taking most migraine medications while pregnant or nursing. For moderate to severe migraine, talk with a doctor to discuss the safest treatment options.

For people who get migraine headaches regularly, some medications can help to reduce the number and severity of episodes.

Antihypertensives

Antihypertensive drugs lower blood pressure, usually in people with high blood pressure. There are numerous types of antihypertensive drugs that might help to prevent migraine headaches, such as:

  • beta-blockers
  • angiotensin-converting enzyme (ACE) inhibitors
  • calcium channel blockers

Anticonvulsants

Anticonvulsant drugs treat seizures in people with epilepsy. They work by reducing activity in the brain, which can reduce the risk of a migraine headache.

Examples of anticonvulsants for treating migraine include topiramate (Topamax) and valproic acid (Depakene).

Antidepressants

Antidepressants often work to increase the availability of serotonin in the brain. Some of these drugs could also help to prevent migraine headaches. Examples include amitriptyline (Elavil) and venlafaxine (Effexor).

CGRP inhibitors

The FDA has approved erenumab (Aimovig) for preventing migraine headaches. It blocks the activity of calcitonin gene-related peptide (CGRP), which is a molecule typically involved in migraine episodes.

Other CGRP inhibitors include galcanezumab (Emgality) and fremanezumab (Ajovy).

Eptinezumab-jjmr (VYEPTI)

In 2020, the FDA approved the use of eptinezumab-jjmr (VYEPTI) for migraine prevention in adults. Treatment with this medication involves a doctor administering this drug intravenously for 30 minutes every 3 months.

Cefaly

The Cefaly transcutaneous electrical nerve stimulation device is a relatively new form of preventive treatment for migraine. The device uses an electrical current to stimulate the trigeminal nerve, which is involved in migraine.

The device may help reduce the number of days that people experience a migraine. However, more research is necessary.

SPG nerve block

The sphenopalatine ganglion (SPG) is a group of nerve cells linked to the trigeminal nerve. Applying local anesthetics to this group of nerve cells can reduce sensations of pain related to migraine.

Doctors can apply medication to this area by using small tubes called catheters. They can place these tubes inside the person’s nose and then insert numbing medication through the tube using a syringe.

The risks associated with using OTC analgesics are relatively low. However, they may cause mild side effects in some people.

Triptans can cause side effects that include:

  • dizziness
  • nausea
  • pain or heaviness in the throat, chest, or head
  • dry mouth
  • burning or prickly feeling on the skin
  • indigestion
  • hot flashes

Other prescription medications for treating migraines have more risks. For example, ergot alkaloids can cause hypertension, vascular problems, and thrombosis or blood clots. Doctors avoid using ergot alkaloids where possible.

Botox can also have many possible side effects, such as numbness or mild nausea. Some of the side effects of Botox are more serious, such as vision problems and breathing difficulties.

Most drugs for preventing migraine headaches are relatively low risk. However, they may cause side effects, such as constipation, muscle spasms, and cramps.

It is important to contact a doctor if a person experiences any side effects. It is also essential to take migraine medication as a doctor prescribes. Overuse may lead to medication overuse headaches, which may increase the risk of migraine frequency.

Certain home remedies for migraine headaches can help a person manage symptoms either instead of or alongside medication.

Some people experience migraine headaches after certain triggers. Identifying what these triggers are can help to reduce the episodes of migraine without medication.

Examples of migraine triggers can include:

  • tiredness
  • caffeine
  • hunger
  • strong stimulation of the senses, such as loud noises or flashing lights
  • stress
  • certain foods

Triggers for a migraine will differ from person to person. Keeping a diary of when a migraine occurs to work out the potential triggers might be helpful.

Migraine headaches can cause oversensitivity to light. Some people find it helpful to lie down in a darkened room during an episode. An ice pack on the head might also reduce some pain.

There are many possible drugs for treating migraine headaches. These broadly include medications for treating symptoms as they occur and those for preventing migraine from happening.

OTC medications for treating acute migraine headaches can work for many people. In moderate to severe cases, doctors may recommend prescription drugs, such as triptans. It is also possible to prevent migraine headaches with anticonvulsants.

All drugs have risks and side effects. OTC medications or triptans are generally safe for most people but can cause some side effects. Other drugs, such as Botox, have more severe potential side effects.

If a person experiences migraine headaches, it is best to contact a doctor for advice. They can help create a suitable treatment plan and advise on ways to manage symptoms.