The goals of preventative therapy are to reduce the frequency, severity, and duration of headaches.
The prescription medications listed below are for the prevention of migraines:
- Dosing: Every 3 months (12 weeks)
- Possible side effects: Headache, facial muscle weakness, drooping of the eyelids, muscle spasm, muscle tightness, injection pain, rash*
- Dosing: Daily
- Possible side effects: Congestive heart failure, slow heart beat, bronchospasm (spasms of the bronchiole tubes in the lungs), anorexia (weight loss), nausea and vomiting, diarrhea, abdominal pain, fatigue, cold extremities, dizziness or lightheadedness*
- Dosing: Daily
- Possible side effects: Congestive heart failure, slow heart beat, diarrhea, difficulty sleeping, dizziness or lightheadedness, drowsiness, dry eyes, headache, nausea or vomiting, unusual tiredness or weakness, cold extremities, shortness of breath, ringing in the ears*
- Dosing: Daily
- Possible side effects: Drowsiness (sedation or fatigue), weight gain, increased appetite, depression, restlessness, trembling or uncontrolled movements of the face, arms and legs, slow movement, stiffness in older individuals*
- Dosing: Daily
- Possible side effects: Co-ordination problems, difficulty concentrating, slow thinking, confusion and forgetfulness, dizziness, tiredness, tingling, headache, upper respiratory tract infection (e.g., colds, bronchitis), drowsiness*
* This is not an exhaustive list. Please consult your doctor to find out if the product is right for you.
There are also several natural health products that can be used for the prevention of migraines.
Natural health products
- Dosing: Daily
- Possible side effects: Stomach upset, vomiting, nausea, diarrhea, appetite suppression, allergic reactions; consult your doctor if migraine frequency increases, and associated nausea and vomiting persist or worsen*
- Dosing: Daily
- Possible side effects: Drowsiness, diarrhea, nausea, vomiting, abdominal pain*
- Dosing: Daily
- Possible side effects: Hypersensitivity/allergy, gastrointestinal discomfort, sore mouth, mouth ulcers*
- Dosing: Daily
- Possible side effects: Burping, headaches, drowsiness, constipation, upset stomach, hair loss, depression, skin or eye discoloration, skin and allergic reactions, fatigue, difficulty breathing or exhaling, itchy eyes, bad breath, itching, discolored stool*
* This is not an exhaustive list. Please consult your doctor to find out if the product is right for you.
Talk to your family doctor or a specialist who has expertise in treating and diagnosing headaches to find out how preventative, acute, and alternative treatments may benefit you.
The goal of acute therapy is to relieve your symptoms after a migraine or headache starts.
Acute treatment options for migraines or headaches include:
Acute migraine treatment
Analgesics (general painkillers)
- Possible side effects: Abdominal pain, heartburn, nausea or vomiting, bloating, diarrhea or constipation, ringing or buzzing in the ears, nervousness, sleeplessness, dizziness or a change in vision, itching, fluid retention, skin rashes, skin reddening, blisters, blood in vomit, bloody or black stools*
- Possible side effects: Nausea, vomiting; stomach irritation or pain; bruising; gastrointestinal bleeding; allergic reaction; loss of hearing, ringing or buzzing in the ears, or bleeding*
- Possible side effects: Allergic reaction (wheezing, rash, or itching). Taking more than the maximum daily dose may cause severe or possibly fatal liver damage*
- Possible side effects: Allergic reaction (wheezing, rash, or itching), rapid heart rate, nervousness, and sleeplessness. Taking more than the maximum daily dose may cause severe or possibly fatal liver damage*
- Possible side effects: Nausea, vomiting, indigestion and/or stomach pain, drowsiness, lightheadedness and dizziness, constipation and gas, skin rash and itching, small pupils, fast or irregular heart beat, irritability, tremor, lack of coordination, difficulty thinking, poor memory and judgement, decreased attention, mood swings, exaggeration of personality traits, drug dependence can develop*
Triptans (Serotonin Receptor Agonists)
- Possible side effects: Pain, pressure or tightness in any part of the body (including chest and throat); sensations of heaviness; unusual sensations including numbness, tingling; heat/burning or cold; flushing (redness of the face lasting for a short time); nausea or vomiting; dizziness; drowsiness; tiredness; weakness; irregular or rapid heart beat*
- Possible side effects: Sensations of pain, pressure, or tightness in the chest, neck, throat, jaws, arms or leg; sensation of tingling, heat, heaviness, or pressure; nausea or vomiting; dizziness; drowsiness; tiredness; muscle weakness; muscle aches and pains; difficulty swallowing; dry mouth; headache; stomach pain; discomfort inside the nose (nasal spray); nose-bleed (nasal spray); irregular or rapid heart beat*
- Possible side effects: Dry mouth; sensations of pain, pressure or tightness in the chest, neck, throat, jaw, arms or legs; sensations of tingling, heat, heaviness or pressure; headache; dizziness; tiredness; muscle pain; nausea or vomiting; drowsiness; irregular or rapid heart beats*
- Possible side effects: Nausea, sleepiness, dizziness, tingling sensation, headache, dry mouth, shortness of breath, wheeziness, heart throbbing, increased blood pressure, fast heart rate or irregular heart beat*
- Possible side effects: Sensations of pain, pressure or tightness in the chest, neck, throat, jaw or arms; shortness of breath, wheezing, heart throbbing; swelling of face, lips, eyelids; skin rash, skin lumps, or hives; feeling weak, dizziness, feeling sleepy or drowsy, tingling, difficulty swallowing, nausea and stomach pain/cramps*
- Potential side effects: Sensations of pain or pressure in the chest, throat, neck, or jaw; dizziness; tiredness; headache (other than a migraine headache); feeling of tingling; numbness; feeling hot or cold; allergic reaction*
- Potential side effects: Sensations of heaviness, pressure, tightness or pain in the chest, throat, neck, jaw and/or upper limb; dizziness; drowsiness; ear, nose, and throat infections; nausea and vomiting; headache; dry mouth; sensation of numbness, tingling, feeling hot, pain in any part of the body including chest, neck, jaw and throat; feeling of tingling; feeling of warmth or flushing; general sick feeling and tiredness*
Opioids
Potential side effects: Drowsiness and sleepiness, dizziness, nausea and vomiting, confusion, weakness, nervousness, drug dependence, blurred vision, unpleasant taste*
Ergots
- Potential side effects: Nasal irritation or congestion, excessive sneezing, runny nose, taste disturbance, application site reactions; nausea and vomiting; numbness or tingling in your fingers and toes; pain, tightness or discomfort in your chest; muscle pain or cramps in your arms and legs; weakness in your legs; temporary speeding or slowing of your heart rate; swelling or itching*
* This is not an exhaustive list. Please consult your doctor to find out if the product is right for you.
There are also several natural health products that can be used for the treatment of migraines.
Natural health products
- Possible side effects: Skin irritation (for topical products) or allergic reaction may occur*
- Possible side effects: Allergic reactions and side effects may occur. Talk to your doctor before using.
* This is not an exhaustive list. Please consult your doctor to find out if the product is right for you.
Taking acute headache medications – including over-the-counter pain relievers and prescription medications – too often can result in more frequent headaches. This is called medication overuse headache.
To help prevent medication overuse headaches:
Do not take over-the-counter pain relievers (e.g., ASA) for more than 14 days/month.
Do not take acute prescription medications (e.g., triptans) for more than 9 days/month.
Alternative Therapy
For some people, behavioural therapy may help reduce the frequency and severity of migraine attacks. But it can also be a means for coping with the stress caused by headaches or help the sufferer function. For individuals experiencing frequent and severe headaches, behavioural methods are usually combined with drug therapy.
Behavioural therapies used by people with frequent headaches and migraines can include relaxation techniques (e.g., meditation, deep breathing), bio-feedback, and cognitive behavioural therapy (CBT). Other behavioural treatments that are supported by clinical experience include aerobic exercise, sleep regulation, dietary regulation, and smoking cessation.
For those looking for alternative pain management, there are a wide variety of possible treatments to choose from, including acupuncture, chiropractic, massage, body work, Reiki, and magnets.
If you're living with Chronic Migraine and think you could be doing better, talk to your doctor about finding the treatment that's right for you.
For tips and tools designed to help you start the conversation with your doctor, visit the Talking to Your Doctor.