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Which Drugs Are Most Effective in Treating Migraines

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A migraine is a neurological condition primarily marked by a throbbing, pulsating headache on one side of the head. Migraines often feature nausea, vomiting, and photophobia (sensitivity to light). A migraine attack may be mild or severe and may worsen with physical activity and specific noises or scents. An attack can last for hours or days. With migraines coming off as debilitating, they can impede your regular activities adversely.

Migraines affect people differently. For some, it features a warning symptom, known as an “aura.” According to a report, 39 million Americans and one billion people worldwide are plagued with migraine symptoms, making it the third most common health condition globally. Migraines are also the twelfth most prevalent cause of disability in the United States.

What Causes Migraines?

While experts cannot tell the roots of migraines, it’s thought to result from abnormal brain activity affecting nerve signaling. Sometimes, an overactive nerve in the brain releases signals affecting certain chemicals and blood vessels. To date, scientists worldwide can’t decipher why this happens.

However, it’s pertinent to note that migraine attacks often have triggers. Notable mentions include:

Stress 

Stress (physical, emotional, or psychological) is a common migraine trigger in susceptible individuals. When you exert stress on the body, the brain releases cortisol and other chemicals that can cause a migraine. Additionally, emotional responses like worry, anxiety, and excitement can prompt the release of chemicals with migraine-triggering attributes. 

Frequent Use of Pain Relievers 

Analgesics employed in relieving headaches can also prompt the release of migraine-causing chemicals. 

Hormonal Fluctuation

Many women experience migraines during their menstrual cycles. Birth control medications and hormone replacement therapy result in hormonal fluctuations that foster migraines. 

External Stimuli 

Bright or flashing lights, specific sounds, and smells prompt migraine episodes in vulnerable individuals. Weather changes, including strong winds or storms, may trigger migraines. 

Phases and Symptoms of Migraine

A doctor will determine whether you have a migraine by evaluating your symptoms and medical history to rule out other disorders. After thorough analysis, the doctor may prescribe a brain scan to check for tumors or a stroke.

Each migraine phase features accompanying symptoms, including:

Prodrome 

Prodrome is the pre-headache phase of migraines. It comes with these symptoms: 

  • Light sensitivity
  • Mood swings
  • Bloating and constipation
  • Frequent yawning 
  • Food craving
  • Hyperactivity 

Prodrome phase symptoms may begin hours or days before the onset of migraine headaches.

Aura

The aura phase begins gradually and can last for 60 minutes. Not everyone experiences this phase, as others might get auras with headaches. Aura symptoms are mostly optical and can include: 

  • Tunnel vision
  • Temporary vision loss
  • Visual hallucinations (wavy lines, black dots, or flashes of light)
  • Ringing ears
  • Speech difficulties 
  • A sensation of pins and needles pricking the arms or legs. 
  • Weakness or numbness in one side of the body.

Attack 

The attack phase is the onset of headaches. It often begins as a dull ache that progresses into a throbbing, drilling, or pulsating headache, typically lasting 4 – 72 hours. For some patients, the sensation felt is reminiscent of an icepick placed on one side of their head. However, the attack’s frequency and intensity vary. 

Migraines may occur rarely or several times monthly. While attacks could be mild in some patients, they might acutely debilitate others. 

Postdrome 

The final phase of a migraine episode lasts up to a day. Tagged as the “migraine hangover,” the postdrome envelopes these symptoms: 

  • Muscle pain or weakness
  • Lack of appetite or peculiar food cravings
  • Feeling elated or unusually happy

Most Effective Drugs for Treating Migraines

Despite the advancement of modern medicine, there’s no known cure for migraines. Regardless, you can access vital medications to prevent and stop symptoms. 

The most effective drugs classes for treating migraines include: 

Pain relievers 

Over-the-counter pain relievers are crucial in relieving migraine symptoms once they show up. Approved pain relievers for treating migraines include Excedrin Migraine, Advil Migraine, and Motrin Migraine. 

Despite their healing properties, improper usage can cause rebound headaches or dependency. Thus, patients should only use them twice or thrice weekly.

Triptans 

Prescription drugs like Sumatriptan (Imitrex) and Maxalt (rizatriptan) block pain-causing pathways in the brain to relieve migraine symptoms. Triptans come in several forms, including pills, shots, or nasal sprays. 

Anti-nausea Drugs 

Patients might get respite from migraines accompanied by nausea and vomiting with anti-nausea medications like Metoclopramide or Chlorpromazine. 

CGRP Antagonists 

Rimegepant (Nurtec ODT) and Ubrogepant (Ubrelvy) are approved to treat aura-free migraines. These medications are effective in treating migraines characterized by nausea and light sensitivity. 

Opioid Drugs

Narcotic opioid drugs are effective treatment modes that combat migraine headaches. However, due to the addiction levels attached, these drugs should come in as a last resort. Doctors prescribe opioids when other drug classes are inefficacious. 

Other Drugs for Treating Migraines  

Other drugs can treat migraines. While paracetamol is  one of the most tried drugs, it’s not reported as a very effective medication in migraine treatment.

That said, other drug forms, including antidepressants, beta-blockers, calcium channel blockers, and Botox injections, can treat and prevent migraine attacks with different degrees of effectiveness.  

Lifestyle Changes for Treating Migraines

Beyond drugs, people with migraines can adopt these lifestyle changes to make their condition bearable:

Keeping a Migraine Journal

A migraine journal helps patients identify peculiarities that tell them their migraine form. It also helps the doctor make accurate diagnoses and prescribe the best treatment mode to nullify the migraine effects. 

Get Quality Sleep 

Maintaining a regular sleep routine is beneficial for migraine patients. Lack of adequate quality sleep can trigger or worsen migraine attacks. 

Thus, patients should go to bed and wake up at similar times daily. Avoiding electronic devices for up to two hours before bedtime is also vital in improving sleep quality. 

Regular Exercises 

Patients can reduce the intensity of their attacks by engaging in 30 – 50 minutes of moderate exercising three to five times weekly. Exercises trigger the release of endorphins that relieve stress, pain, and migraine episodes. 

Healthy Nutrition

Eating foods rich in protein, healthy fats, and fiber while avoiding processed and sweetened meals can prevent sugar level dips that can trigger migraine. Patients should also stay hydrated as electrolyte loss through sweating and urination may trigger migraine episodes. 

Final Thoughts

A migraine is a severe condition that can interfere with every living aspect and could also be the prelude to more severe health conditions. If migraine headaches do not respond positively to treatment, seeing a doctor immediately should be your following line of action.

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