Fast-acting migraine medicine tin swipe retired a headache. But according to Christopher Gottschalk, MD, head of nan Yale Headache & Facial Pain Center, this pain-free anticipation often comes arsenic a astonishment to galore who unrecorded pinch nan neurological condition. The velocity and occurrence of each supplier whitethorn alteration pinch each attack.
“But 1 of nan things I stress to group is I want to beryllium judge that erstwhile you dainty a migraine, you consciousness wholly amended successful an hr aliases two,” he says. “And I opportunity that to group each azygous day.”
Total aliases partial alleviation whitethorn travel good earlier nan 2-hour people for some. Ask your expert to spell complete nan pros and cons of each your curen choices. They’ll thief you find nan medicine that useful champion for your symptoms.
What Medications Treat Migraine?
If you get only mild caput symptom each now and then, it’s worthy asking your expert if acetaminophen aliases precocious doses of nonsteroidal anti-inflammatory narcotics (NSAIDs) for illustration aspirin, ibuprofen, aliases naproxen mightiness beryllium correct for you.
But group pinch migraine who get bully results from wide painkillers are “few and acold between,” says Anne Yacoub, MD, an adjunct professor of neurology and co-director of nan Johns Hopkins Headache Center.
The bully news is location are a increasing number of migraine-specific narcotics utilized to easiness headaches aft they start. These medications target circumstantial nerves and pathways that extremity aliases reverse nan migraine process. You whitethorn perceive your expert telephone this acute treatment.
Here’s a breakdown of narcotics utilized to dainty acute migraine headaches:
Triptans. These narcotics enactment connected a encephalon chemic called serotonin. They besides origin your humor vessels to constrictive and apt little levels of calcitonin gene-related peptide (CGRP). CGRP is simply a pain-related macromolecule that plays a large domiciled successful triggering migraine attacks.
All triptans activity successful a akin way. But it’s difficult to foretell which 1 will activity best. You whitethorn request to effort much than one.
Examples of triptans include:
- Almotriptan (Axert)
- Eletriptan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt, Maxalt-MLT)
- Sumatriptan (Imitrex)
- Zolmitriptan (Zomig ZMT, Zomig)
You tin return triptans arsenic a pill, shot, aliases nasal spray. But immoderate experts opportunity nan changeable is your champion stake for accelerated and reliable results.
Triptans are mostly considered safe. But they usually aren’t recommended for folks with:
- Uncontrolled precocious humor pressure
- Certain bosom and humor alloy conditions
- A higher consequence of a bosom onslaught aliases stroke
In position of broadside effects, you whitethorn not person any. But immoderate group feel:
- A squeezing aliases tingling sensation
- Chest symptom aliases pressure
Tell your expert if immoderate of nan supra symptoms fuss you. They whitethorn alteration nan dose aliases move you to a different migraine medication.
Gepants. Also called CGRP antagonists, gepants activity by blocking calcitonin gene-related peptide. As mentioned earlier, CGRP molecules are released during a migraine onslaught and tin prolong pain. Gepants whitethorn not enactment arsenic accelerated arsenic immoderate different migraine meds, but they thin to travel pinch less broadside effects and wellness worries. For example, they don’t constrict your humor vessels. That makes them a safer replacement to triptans if you person concerns astir your bosom and humor vessels.
There are 3 gepants approved for acute migraine treatment. They are:
- Rimegepant (Nurtec ODT)
- Ubrogepant (Ubrelvy)
- Zavegepant (Zavzpret)
Rimegepant and ubrogepant are taken orally arsenic a pill aliases tablet that dissolves nether your tongue. Zavegepant is utilized arsenic a nasal spray.
Ditans. These narcotics target very circumstantial serotonin receptors that play a domiciled successful migraine pain. But dissimilar triptans, they don’t constrictive your humor vessels. Lasmiditan (Reyvow) is nan only ditan approved for acute migraine treatment. Talk to your expert astir it if you:
- Have a bosom aliases humor alloy condition
- Can’t grip broadside effects from different migraine meds
- Don’t respond good to triptans
Lasmiditan tin origin superior tiredness and problem pinch coordination. And you shouldn’t run immoderate machines aliases instrumentality for up to 8 hours aft you return it. Also, it tin only beryllium taken erstwhile each 24 hours.
Dihydroergotamine. Known arsenic DHE for short, this supplier targets serotonin, dopamine, and immoderate different chemicals progressive pinch migraine. Researchers deliberation this multi-molecule attack mightiness beryllium why DHE useful for group who don’t respond good to triptans.
Studies show this migraine curen whitethorn beryllium a bully prime for group who:
- Wake up pinch a migraine headache
- Have menstrual migraine
- Get other symptom and delicate tegument during a migraine attack
You typically return DHE arsenic a nasal spray aliases changeable you springiness yourself. But you tin get curen done a vein successful your limb if you person caput symptom that lasts much than 72 hours.
Your expert whitethorn springiness you an anti-nausea pill to return pinch DHE. Side effects whitethorn see worsening nausea aliases throwing up.
This supplier whitethorn not beryllium safe for group who have:
- Heart disease
- Uncontrolled precocious humor pressure
- Kidney aliases liver disease
You besides shouldn’t return DHE wrong 24 hours of utilizing a triptan.
When Do You Take Migraine Drugs?
All acute migraine narcotics activity champion erstwhile utilized early during an attack. How early?
“Once nan headache moreover somewhat begins, jump connected it,” Gottschalk says.
Early curen is cardinal for a mates of reasons. One is that symptoms for illustration symptom are easier to dainty erstwhile they’re mild. But nan bigger rumor has to do pinch really these narcotics enactment connected nan migraine process.
The aching and throbbing of a migraine hap erstwhile your trigeminal nervus is triggered, says Gottschalk. Drugs for illustration triptans get free of caput symptom by calming this nerve.
But without accelerated treatment, this irritated process tin dispersed to nerves deeper wrong your encephalon and tense system. And narcotics for illustration triptans mostly activity connected peripheral nerves, for illustration nan benignant successful your look and forehead.
When it comes to taking fast-acting migraine drugs, “Basically, nan doorway is unfastened for a mates of hours successful nan opening of an attack,” Gottschalk says. “And past it beautiful overmuch closes.”
Which Migraine Medication Is Right for You?
There are immoderate cardinal questions to guideline you and your expert toward nan correct medication. Three things Yacoub likes to inquire group pinch migraine are:
- Does your headache symptom ramp up really quickly?
- Do you get nausea early during an attack?
- Do you often aftermath up pinch a headache?
If group reply yes to immoderate of those things, Yacoub says shots and nasal sprays thin to beryllium a bully first choice. That’s because these non-oral forms get migraine medicine into your bloodstream faster than a pill and bypass your gut.
But nan correct migraine medicine for you depends connected respective things. Some topics to bring up pinch your expert are:
- If your headache symptom builds slow aliases fast
- If you person headaches that past a agelong time
- Whether you’d alternatively return a pill
- Your property and different wellness conditions
You’ll besides want to show your expert astir immoderate medicine you’ve tried earlier that hasn’t worked.
When to Change Your Migraine Medication
In general, acute curen shouldn’t beryllium utilized much than 2 aliases 3 times a week. One interest is thing called medicine overuse headache. That’s nan thought that symptom-relieving narcotics whitethorn origin much headaches complete time.
There’s nary beardown grounds that each migraine-specific narcotics lead to medicine overuse headache. In fact, gepants are a type of acute curen that tin besides beryllium utilized arsenic preventive therapy. But according to Gottschalk, nan main interest isn’t that taking excessively overmuch of these will bring connected much migraine attacks down nan road.
“The speech really should beryllium that if you consistently person to dainty your headaches much than 3 times a week, apparently we’ll request to do more,” he says.
Talk to your expert astir different acute curen aliases preventive therapy if you have:
- More than 4 headaches a month
- Eight aliases much headache days a month
- Headaches that are debilitating
- A mediocre consequence to your existent abortive drugs
Good migraine prevention should not only make your migraine attacks little frequent, but besides make your headaches little severe. Preventive therapy whitethorn besides boost your consequence to abortive narcotics erstwhile you do request them.
Photo Credit: jcphoto/Getty Images
Christopher Gottschalk, MD, director, Yale Headache & Facial Pain Center; professor of neurology, Yale School of Medicine.
Anne Yacoub, MD, co-director, Johns Hopkins Headache Center; adjunct professor of neurology, Johns Hopkins University School of Medicine.
UpToDate: “Acute curen of migraine successful adults.”
American Family Physician: “Acute Migraine Headache: Treatment Strategies,” “Migraine Headache Prophylaxis.”
Merck Manual: “Migraine.”
American Migraine Foundation: “What to Know About nan New Anti CGRP Migraine Treatment Options,” “Dihydroergotamine (DHE) for Migraine Treatment.”
The New England Journal of Medicine: “Ubrogepant for nan Treatment of Migraine.”
Headache: “Gepants,” “Dihydroergotamine (DHE) – Then and Now: A Narrative Review.”
The Journal of nan American Medical Association: “Acute Treatments for Episodic Migraine successful Adults: A Systematic Review and Meta-analysis.”
JAMA Network Open: “Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine: A Systematic Review and Meta-analysis.”
The Journal of Headache and Pain: “Lasmiditan system of action – reappraisal of a selective 5-HT1F agonist.”More article :Migraine: What to Do When Your Pain Is Dismissed