The longer you wait to take your acute migraine medication, the less effective it will be.
You start to feel a little “off.” You feel more irritable and easily agitated, and you keep snapping at your loved ones. And is it just your imagination, or is that bedroom light just way too bright this morning?
After your first migraine, you will likely start to recognize the early warning signs of a migraine. Still, you might be tempted to play it safe, wait it out, and be absolutely, positively sure it’s a migraine before you take your acute migraine treatment.
There’s just one problem with that method: Generally, the longer you wait to take your acute migraine medication, the less effective it will be. “With the way … migraine signaling works in the brain, you have the best chance of turning it off [if] you take something right when you start to feel symptoms,” says Sylvia Mohen, MD, neurologist in New York City.
Before the Headache
To make early treatment of migraines easier, most people notice a pretty predictable pattern with their migraine episodes. Often, there is a prodrome phase and/or an aura before the actual headache begins.
The prodrome phase (or “pre-headache phase”) may last a few hours or even days before the actual headache. During this time, you may notice mood changes, increased urination, fatigue, sensory sensitivity, cravings, and nausea.
Aura usually lasts between five to 60 minutes. Aura can be more noticeable than the nonspecific symptoms of the prodrome phase. That said, only about a third of people with migraines actually have aura. This phase is notorious for visual disturbances (like blurriness, blind spots, and flashing lights) and numbness or tingling.
“Auras can be very scary. They can be very upsetting and there’s a wide spectrum of what you can experience,” says Dr. Mohen. Once you are able to recognize symptoms of aura, however, they can be a helpful clue that a migraine is coming.
When to Take Action
If your migraines seem to follow a predictable pattern with prodrome and/or aura, your body is giving you a signal to take your medication.
“You treat the migraine early by taking your acute treatment as soon as you possibly can. So if you were prescribed a triptan or an ergot, take it as soon as possible,” says Dr. Mohen. “If you take one of the over-the-counter drugs, you can definitely take that as soon as you feel something coming on as well.”
Early treatment for migraines involves lifestyle changes, too. When early migraine symptoms appear, it’s a good idea to avoid triggers, such as bright sunlight, dehydration, or your personal trigger foods. It may also help to try relaxation techniques, such as meditation, breathing exercises, or calming yoga.
When migraine-friendly lifestyle choices and early medication are combined, you might be able to stave off the migraine—or at least lessen the severity of it.
“People experience migraines in a variety of different ways and often have other issues going on,” says Dr. Mohen. “I think it’s important for patients to work very closely with their doctor to find the right fit for treating their migraine,” she says.
Sylvia Mohen, MD, is a neurologist at New York Neurology Associates, P.C.
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The benefits of treating the migraine early
are you have
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a better chance of turning it off
if you start treating it early.
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Some medications are actually more effective
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if you take them right at the beginning of the migraine
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or when you start to first experience symptoms.
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There's a number of different symptoms that indicate
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a migraine is starting.
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The migraine prodrome, where you may have symptoms
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of fatigue, you may have symptoms of nausea
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that you may start to recognize as being the first sign
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that the migraine is coming on.
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People who have aura may recognize the aura symptoms
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initially before the migraine starts.
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Auras can look like a lot of different things.
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It can be transient visual phenomenon,
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meaning you see something shimmering in your vision,
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or you lose part of your vision,
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or part of your vision just goes blurry
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or becomes pixelated.
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You may have loss of sensation on half of your body.
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There are some people who become even unable
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to move half their body with auras.
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There's a wide spectrum of what you can experience.
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You treat the migraine early by taking
your acute treatment
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as soon as you possibly can,
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so if you were prescribed a triptan or an ergot,
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take it as soon as possible.
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There's a new class of medications that have come
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to the market recently called the gepants.
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You take one of the over-the-counter drugs.
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You can definitely take that as soon as you feel
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something coming on as well.
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There's a number of lifestyle changes,
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lifestyle modifications, people can make
to stop migraines
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as soon as they start.
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Migraines can sometimes be brought on
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by excessively staring at screens,
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so if you're at work and you're really
kind of hyperfocused
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on the screen, sometimes taking a break
and sitting down
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and closing your eyes for a few minutes
can be helpful.
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Sometimes people have particular triggers
like strong smells.
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Removing yourself from the environment
can be helpful.
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Sometimes people have exercise-provoked migraines
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and stopping activity can be helpful.
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Sometimes finding the right migraine fit,
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there can be a bit of an art to it,
so I think
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it's important for patients to work very closely
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with their doctor to find the right fit for treating their migraine.