For some patients, migraines are extremely painful and debilitating. The intense pain, combined with light sensitivity, nausea, and vision impairment can take a serious toll. An estimated 38 million Americans get migraine headaches annually. Migraines are the second most common type of headache. Fortunately, pharmacies offer many different types of medications the help patients tolerate their migraines and make them more comfortable.
It can be difficult to navigate the pain and symptom management for those who experience migraines regularly. It can also be challenging to determine when patients should talk to their doctor regarding a prescription treatment when over-the-counter solutions are not effective.
Migraines and Over-the-counter Medication
Nonsteroidal anti-inflammatory drugs (NSAIDS) are typically the first line of defense when it comes to treating migraines. NSAIDS include ibuprofen and naproxen. Patients may also opt for an aspirin or acetaminophen for the treatment of migraines. Because migraine headaches are due to inflammation, aspirin or acetaminophens do not contain the anti-inflammatory properties and are less effective.
Some types of over-the-counter pain medications are actually specifically designed to treat migraines. One example is Excedrin. This medicine contains a combination of acetaminophen, aspirin and caffeine. Caffeine can be especially helpful in battling migraines as the caffeine aids in constricting and shrinking inflamed blood vessels.
Prescription Treatments
When discussing prescription medication options for migraines, it is important to evaluate the frequency and intensity of the migraines. Patients who experience several migraine headaches each month and find that over-the-counter medications such as Advil, Aleve are ineffective, often benefit from discussing a prescription medication with their doctor.
Prescription Medications for Migraines
The class of drugs which are most commonly prescribed for treating migraines are called triptans. These medications are all intended to be taken on an as-needed basis during the onset of a migraine headache. Triptans include the following drugs: Sumatriptan (Imitrex), Zolmitriptan (Zomig), Rizatriptan (Maxalt), and Eletriptan (Relpax). The previously mentioned drugs are the most effective and most popular. In addition, these drugs are known for being the safest options with the best evidence. While the four drugs are quite similar, most doctors will prescribe a selected drug depending on individual insurance coverage and out-of-pocket costs.
Triptan medications are typically administered in a pill form. However, some of the drugs can also be administered in a nasal spray or received through an injection. The nasal spray and injection work especially well for migraine patients who suffer from nausea and vomiting symptoms. Taking the medication via an injection or nasal spray allows the medication to remain in the patient’s system, even if they become sick.
Daily Migraine Prevention Medication
Some patients prefer to take medication in a preventative manner rather than for treatment as needed. There are a range of drugs which are available for off-label use. Off-label use means the drugs were originally designed to treat a different issue, but were found to help in treating another problem. These drugs include beta blockers, such as Propranolol. Propranolol is a medication used to treat high blood pressure. Anti-depressants such as Amitriptyline, Amoxapine and Desipramine have also been effective in regular migraine prevention. Valproic acid, an anticonvulsant seizure medication has also proven to be helpful in preventing migraines for some patients. It is important for patients to know that beta blockers and anti-seizure medications can have severe side effects. In most cases, doctors prescribe these drugs as a last resort when all other medication and treatment options fail.