Acute Migraine Medication
Acute migraine medication attempts to relieve or stop the progression of an attack or to abort it once it has begun.
Acute treatment should be taken as early as possible in the headache phase of an attack to prevent its escalation and to increase the drugs effectiveness. The two main types of acute treatments used are Analgesics and Triptans.
Analgesics are painkillers that work by reducing the person’s perception of the attack, effectively numbing the pain-affected area. Many are available over-the-counter (OTC).
Aspirin is a traditional first line painkiller. It has anti-inflammatory effects, which affect some of the mechanisms that make a migraine hurt.
Paracetamol is another common analgesic but unlike aspirin, it does not have an anti-inflammatory effect.
Combination Alalgesics are so termed because they consist of two drugs working together to attack thepain. Codeine and Caffeine are the most common combination painkillers. Anti-nausea (anti-emetic) drugs can also be used in combination with painkillers to treat migraine.
2. Non Steroidal Anti-Inflammatory Drugs
NSAIDS are also used, generally, for more severe attacks. They attack inflammation. Examples of NSAIDs would be nurofen, difene, naprosyn, etc.
- The soluble forms of the drugs listed above are usually better for people with migraine because most people experience stomach symptoms as part of their attack which can slow down the absorption of ordinary tablets.
- OTC analgesics can be dangerous if taken incorrectly. Please also note that if the migraine does not respond to the stated dose of the analgesic, taking extra doses won’t help and in fact can lead to Rebound Headache through overuse as well as stomach irritation.
Triptans are the migraine specific, prescription-only drugs that became available in Ireland in the 1990s. These drugs target specific groups of serotonin receptors in the brain that are known to be closely involved in migraine attacks.
There are six Triptan drugs available in Ireland and they are now considered to be the first line treatment of choice. They are:
Studies have shown that treating the headache with triptans will resolve the pain within two hours in up to 80% of cases, but only if the drug is taken early when the pain is milder.
Some people find that the headache will recur after taking a Triptan in which case a second dose can be taken. Some of the triptans are available in non-tablet form (e.g. nasal spray or dissolving tablet). These are quicker acting and may be useful for people who experience severe nausea.
Triptans are licensed for people aged between 18 and 65, both those with and without aura. They are not suitable during pregnancy. They are also not suitable for people who have a history of any type of cardiovascular disease or high blood pressure.