What are the treatment options for migraine?
A separate leaflet called 'Medicines to Treat Migraine Attacks' provides details of the various treatment options. A brief summary is given here.
Painkillers
Paracetamol or aspirin work well for many migraine attacks. (Children under 16 should not take aspirin.) Take a dose as early as possible after symptoms begin. If you take painkillers early enough, they often reduce the severity of the headache, or stop it completely. A lot of people do not take a painkiller until a headache becomes really bad. This is often too late for the painkiller to work well. The only solution may then be to find a a quiet, dark room to 'sleep it off'.
Take the full dose of painkiller. For an adult this means 900 mg aspirin (usually three tablets) or 1000 mg of paracetamol (usually two 500 mg tablets). Repeat the dose in four hours if necessary. Soluble tablets are probably best as they are absorbed more quickly than solid tablets.
Anti-inflammatory painkillers
Anti-inflammatory painkillers probably work better than paracetamol or aspirin to ease a migraine. (Although, strictly speaking aspirin is an anti-inflammatory painkiller.) They include ibuprofen which you can buy at pharmacies or get on prescription. Other types such as diclofenac, naproxen, or tolfenamic acid need a prescription.
Dealing with nausea and sickness
Migraine attacks may cause nausea (feeling sick) or vomiting. The nausea causes poor absorption of tablets into your body. If you take painkillers, they may remain in your stomach and not work well if you feel sick. You may even vomit the tablets back. Tips that may help include:
Combinations of medicines
Some tablets contain both a painkiller and an anti-sickness medicine. For example, Migraleve, Paramax, Migramax, and Domperamol. They may be convenient. However, the dose of each constituent may not suit everyone, or be strong enough. You may prefer to take painkillers and anti-sickness medicines separately so that you can control the dose of each.
Triptan medicines
A triptan is an alternative if painkillers do not help. These include: almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan. They are not painkillers. They work by interfering with a brain chemical called 5HT. An alteration in this chemical is thought to be involved in migraine. Some triptans work in some people and not in others. Therefore, if one triptan does not work, a different one may well do so. Most people who have migraine can usually find a triptan that works well for most migraines, and where side-effects are not too troublesome.
Do not take a triptan too early in an attack of migraine. (This is unlike painkillers described above which should be taken as early as possible.) You should take the first dose when the headache (pain) is just beginning to develop, but not before this stage. (For example, do not take it during the premonitory or aura phase until the headache begins.)
Preventing migraine attacks
A medicine to prevent migraine attacks is an option if you have frequent or severe attacks. It may not stop all attacks, but the number and severity are often reduced. Medicines to prevent migraine are not painkillers, and are different to those used to treat each migraine attack. A doctor can advise on the various medicines available. Another leaflet called 'Medicines to Prevent Migraine Attacks' provides more details.
