The exact cause of migraine headaches is a bit of a mystery. While they are not completely preventable, they can be treated with different types of medications. There are two main ways to treat migraines: the preventive route with medications that are taken every day, and abortively, with medications that are taken after the migraine begins.
Tricyclic Antidepressants
Tricyclic antidepressants are a prophylactic migraine medication, meaning they are taken regularly to stop a migraine from forming in the first place. Tricyclic antidepressants affect the levels of serotonin in the nervous system, which is thought to contribute to migraines in some people. Some examples of tricyclic antidepressants are amitriptyline and nortriptyline.
SSRIs and SNRIs
SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) are also antidepressants, and affect the brain's serotonin and norepinephrine levels. They are not as researched for migraine use as tricyclic antidepressants, according to the Mayo Clinic, but have shown promise as prophylactic migraine medications. Venlafaxine is an SNRI that may be prescribed for migraine prevention.
Beta Blockers
Beta blockers are not just heart medications: they help prevent certain types of migraines when taken regularly. According to the University of Maryland Medical Center, researchers are not entirely sure how beta blockers prevent migraines. They are thought, however, to affect changes in the brain's blood vessels. Beta blockers commonly used for migraine prevention include propranolol and atenolol.
Calcium Channel Blockers
Calcium channel blockers are commonly used to treat both heart disease and high blood pressure, but show promise in migraine treatment as well. Like beta blockers, the exact way calcium channel blockers prevent migraines is not fully understood. According to the Mayo Clinic, they are effective not only as a prophylactic, but can also relieve migraine aura symptoms. A calcium channel blocker commonly prescribed for migraines is verapamil.
NSAIDs
NSAIDs, or nonsteroidal anti-inflammatory drugs, can help relieve migraine pain once it starts. They are generally more useful for mild or moderate migraine pain, and according to the Mayo Clinic, are much less effective at treating severe migraines once they start. They can be used to treat breakthrough migraine pain, in combination with daily prophylactics. Some examples of NSAIDs for migraine pain include ibuprofen and naproxen.
Mixed Analgesics
The term "mixed analgesics" describes medications that contain more than one active ingredient for migraine treatment. Midrin is a commonly prescribed abortive migraine medication that combines isometheptene, acetaminophen and dichloralphenazone. Mixed analgesics are also available over the counter. Excedrin Migraine can be purchased at pharmacies, and contains aspirin, acetaminophen and caffeine. Mixed analgesics are abortive migraine medications.
Opioids
Opioids are narcotics, and may be helpful in treating moderate to severe migraine pain. Because of their potentially habit-forming nature, the National Pain Foundation reports that they are often a last resort abortive medication. Codeine is a weaker opioid that may be prescribed for migraine treatment.
Anti-seizure Medications
Also called anticonvulsants, anti-seizure medications act on the nervous system to prevent migraines. Like many other prophylactic migraine medications, researchers do not fully understand how anti-seizure medications work for migraines. However, both valproic acid and topiramate have been approved by the FDA for migraine prevention.
