The type of medicine you need for your migraine headaches depends on the severity and frequency of the attacks you experience. People with mild or moderate headaches might be able to treat their symptoms with over-the-counter medications. Other people need stronger prescription medicine, and still others might want to opt for preventive medication when nothing else seems to work.
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Over-the-counter remedies can be used by people with mild migraines. These work well when they are taken as soon as there is a sign of an attack, according to the University of Maryland Medical Center. Non-prescription pain relievers include ibuprofen products such as Advil and Motrin, the anti-inflammatory naproxen product, Aleve, and aspirin. Tylenol and Excedrin Migraine are helpful acetaminophen products. Excedrin Migraine, which also contains aspirin and caffeine, eases the pain of moderate headaches but may not work as well for severe attacks, the Mayo Clinic says. Ulcers, gastrointestinal bleeding and rebound headaches might occur with ibuprofen and aspirin if taken too often over an extended period of time.
Triptans work by maintaining serotonin levels in the brain that play a major role in migraine headaches. People with severe migraine attacks have used them successfully. Sumatriptan or Imitrex is an effective drug available as a pill, nasal spray or injection. Other triptans include Axert, Zomig, Amerge, Maxalt, Frova and Relpax. A new drug, approved by the FDA in 2008, called Treximet, combines sumatriptan and the anti-inflammatory naproxen. It has been found that the combination works better on migraines than either drug alone, according to the University of Maryland Medical Center. Side effects of triptans can include nausea, dizziness, rapid heart rate and muscle weakness. Another prescription drug called ergotamine, marketed under the names Migergot and Cafergot, is not as expensive as triptans, but is also less effective, according to the Mayo Clinic. People who have migraines that last for more than 48 hours might have the best results with ergotamine. There can be side effects of nausea, dizziness and muscle cramps, however.
Migraine headaches are often accompanied by nausea, so medications have been developed to be used with migraine drugs. These anti-nausea products include metoclopramide (Reglan) and domperidone (Motilium). They appear to help the absorption of migraine medications by the intestine.
When other prescription drugs do not work for migraine sufferers, narcotics might be prescribed. These drugs often include codeine, but can also include morphine, meperidine (Demerol), and oxycodone. They are only used as a last resort to fight migraine pain. Side effects include drowsiness, impaired judgment and nausea, and these narcotics can become habit forming, as well.
Drugs to prevent migraines might help people who suffer from two or more severe attacks a month if other medications are not working. They have been known to reduce the frequency and severity of migraine attacks. Prescriptions can include cardiovascular drugs known as beta blockers that are normally used to treat high blood pressure and heart disease, but which have also been found to reduce migraine attacks, according to the Mayo Clinic. Antidepressants, anti-seizure drugs and antihistamines have also been used to prevent migraines. A doctor can help you choose the best medicinal route if you need preventive medication.