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mendingmigraines@gmail.com

Treatments

There are two main categories of migraine treatments: preventative and acute.

Acute treatment aims to terminate the symptoms of the migraine attack as quickly as possible.

Preventative
Acute

Preventative treatment aims to decrease the frequency, severity, and duration of the attacks.

  • Triptan drugs: can ease moderate to severe migraine pain. They increase levels of the neurotransmitter serotonin in the brain, which causes blood vessels to constrict and lowers the pain threshold. 

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  • Ergot derivative medications: bind to serotonin receptors on nerve cells and decrease the transmission of pain messages along nerve fibers. They are most effective during the early stages of migraine.

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  • Non-prescription analgesics or over-the-counter drugs: can ease the pain of less severe migraine headaches.

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  • Combination analgesics: involve a mix of drugs, such as acetaminophen plus caffeine and/or a narcotic for migraine that may be resistant to simple analgesics.

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  • Nonsteroidal anti-inflammatory drugs (NSAIDs): can reduce inflammation and alleviate pain.

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  • Nausea relief drugs: can ease queasiness brought on by migraines.

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  • Narcotics: can be prescribed temporarily to relieve pain. These drugs should not be used to treat chronic headaches.

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  • Ditans: bind to the serotonin 5-HT1F receptor subtype in the brain and work to prevent the trigeminal nerve from releasing CGRP (calcitonin gene-related peptide). CGRP is a small protein that sends signals in the brain and plays an important role in migraine pain.

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  • CGRP antagonists: work to block CGRP from binding to CGRP receptors, which contribute to inflammation and nerve pain in migraines.

Acute Medication Treatments

Preventative Medication Treatments

  • Anticonvulsants: may be helpful for people with other types of headaches in addition to migraine. They increase levels of certain neurotransmitters and dampen pain impulses.

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  • Beta-blockers: used to treat high blood pressure and are often effective for migraine.

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  • Calcium channel blockers: prevent blood vessels from either narrowing or widening, which affects blood flow to the brain.

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  • Antidepressants: work on different chemicals in the brain; their effectiveness in treating migraines is not directly related to their effect on mood. They increase the production of serotonin to help migraines and may also affect levels of other chemicals, such as norepinephrine and dopamine.

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  • CGRP antagonists: work to block CGRP from binding to CGRP receptors, which contribute to inflammation and nerve pain in migraines.

Alternative (Non-Medication) Treatments

  • Natural treatments: include riboflavin (vitamin B2), magnesium, coenzyme Q10, and butterbur (medicinal plant).

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  • Non-drug therapies for migraine: include biofeedback and relaxation training, both of which help individuals cope with or control the development of pain and the body's response to stress.

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  • Lifestyle changes: include exercising regularly, avoiding food and beverages that trigger headaches, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule.

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  • Weight loss: obesity increases the risk of developing chronic daily headaches, so a weight loss program is recommended for obese individuals.

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  • Keep a journal/log: keeping a log of your migraine attacks can help determine the triggers.

Summary: List of Treatments

  • Environmental factors to avoid:

    • Air pollution

    • Weather

    • Light

    • Noise

    • Odors

    • Mold and allergies

  • Foods to avoid:

    • Sugar

    • Salt

    • Gluten

    • Dairy

    • Tyramine

    • Monosodium glutamate, nitrates, nitrites, sulfites

    • Caffeine

    • Alcohol

    • Fasting and weight loss

  • Exercise:

    • Aerobic, high-intensity interval training, strength building

    • Neck exercises

    • The Feldenkrais method

    • Yoga

    • Eye movement exercises

  • Physical

    • Acupuncture

    • Reflexology and massage

    • Chiropractic

    • Music

    • Virtual reality

    • Tai Chi

    • Dental appliances

    • Nasal sinus care

  • Sleep

    • Treating sleep apnea

    • Treating restless leg syndrome

    • Treating Insomnia

  • Supplements

    • Magnesium

    • Coenzyme Q10

    • Riboflavin

    • Vitamin D

    • Vitamin B12 and other B vitamins

    • Zinc

    • Curcumin

    • Alpha-lipoic acid

    • Omega-3 fatty acids

    • Vitamin C and E

    • Melatonin

  • Herbal

    • Boswellia

    • Feverfew

    • Valerian

    • Butterbur

    • Ginger

    • Homeopathic remedies

    • Probiotics

    • CBD/ cannabis

  • Aromatherapy

    • Peppermint

    • Lavender

  • Electric stimulation

    • Transcranial direct current 

    • Transcutaneous electric nerve

    • Non-invasive vagus nerve

    • Transcranial magnetic

    • Implanted electrical

  • Injections and blocks

    • OnabotulinumtoxinA

    • Nerve blocks

    • Sphenopalatine ganglion blocks

  • Surgery

    • Contact point surgery

    • Denervation surgery

  • Mind-body

    • Biofeedback/neurofeedback

    • Meditation

    • Praying and cursing

    • Cognitive behavioral therapy

    • Psychotherapy

    • Hypnosis

  • Acute treatment drugs

    • Triptans

    • NSAIDs

    • Gepants

    • Ditans

    • Opioids

    • Anti-nausea

    • Phenothiazines 

    • Others

    • Setrons

  • Preventative drugs

    • Gepants

    • CGRP monoclonal antibodies

    • Antidepressants

      • Tricyclic

      • SSRIs

      • SNRIs

      • MAOIs

    • Epilepsy drugs

    • Blood pressure drugs

    • Beta-blockers

    • ACEIs and ACE receptor blockers

    • Calcium channel blockers

    • Non-steroidal anti-inflammatory drugs

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