Abortive therapy: This is used to block the acute attack or to control the acute attack.
Simple Analgesics: These include NSAIDS like
- Paracetamol
- Ibuprofen
- Diclofenac
- Combination analgesics- The combination of acetaminophen, aspirin and caffeine is useful in mild to moderate migraine attacks.
- Ergotamine tartrate- This is a sublingual preparation which means it’s placed under the tongue. Care should be taken to not eat or drink anything till the effects of this medicine kick in.
- Dihydroeargotamine
Sumatriptan and other triptan: They bring about the constriction of blood vessels in the brain which reduces the headache. Available as nasal spray, pills and injection.
- Sumatriptan (Imitrex)
- Rizatriptan (Maxalt)
- Almotriptan (Axert)
- Naratriptan (Amerge)
- Zolmitriptan (Zomig)
- Frovatriptan (Frova)
- Eletriptan (Relpax)
- Prednisone
- Dexamethasone
- Prophylactic therapy- Patients suffering from frequent and repeated attacks are put on prophylactic therapy. This will reduce the frequency and severity of the attacks. In most patients, a combination of drugs is used. One needs to be aware about the benefits and side effects of these drugs. You are requested to consult your physician before using any of these drugs.
Beta blockers:
- Propranolol
- Metoprolol tartrate (Lopressor)
- Timolol (Betimol)
- Calcium channel agonist- Verapamil
- Anti-depressants- Amitriptyline and selective serotonin reuptake inhibitors
Serotonin antagonist:
- Carbinoxamine
- Cyproheptadine
- Methdilazine
- Promethazine
Nsaids:
- Naproxen
- Lithium
Anticonvulsants:
- divalproex sodium
- topiramate
If medical management fails or patient remains refractory to this treatment then Occipital Nerve Stimulation is the treatment of choice.