The earlier you take action, the better.
The internet is peppered with advice on how to prevent migraines, but how do you find relief once you’re in the middle of one? If you’re prone to migraines, you know that they’re a complicated syndrome that can be seriously debilitating, and during a migraine attack you’d do just about anything to feel better.
That’s why we asked Mark Green, MD, a neurologist at Mount Sinai Hospital what you should do as soon as a migraine hits, so you can soothe your symptoms and feel like yourself again as soon as possible.
Responding to the First Signs of a Migraine
“When you first have an attack, the worst thing you can do is ignore it and think it’s going to go away,” says Mark Green, MD, neurologist at Mount Sinai Hospital.
For other types of headaches, many people will wait it out and see if the pain goes away on its own. They might not want to prematurely take a pain reliever in case it turns out to be a brief and mild episode. That’s OK for your standard tension headache, but doctors recommend a different approach for migraine.
“When you first develop a migraine, and you have an acute medication, we want you to take it. Take it right away,” says Dr. Green.
Once you’ve had a couple migraine attacks, you quickly learn the early warning signs of a migraine. The prodrome and aura stages of an attack precede the migraine headache itself, and you can become pretty skilled at recognizing the telltale signs.
“The false alarm rate in early migraine is very low,” says Dr. Green. “In other words, when people think, ‘I think I’m going to get a migraine,’ guess what? They’re going to get a migraine.” The longer you wait to treat the migraine, the more resistant it will be to treatment methods.
Early Treatment Options That Work
Migraine treatment has come a long way: Some particularly morbid methods throughout history include hot irons, sticking garlic into an incision in the head, and even drilling a hole in the skull to let out evil spirits, according to the American Migraine Foundation (AMF).
Not surprisingly, none of those methods helped patients in any way, shape, or form. Thankfully, today’s migraine sufferers have safe and effective options to choose from.
“The most common of the acute medications that we use are called triptans,” says Dr. Green.
Triptans were the first class of prescription drugs designed specifically for migraines, and didn’t appear until the 1990s. This medication interacts with receptors in the brain to help turn off the trigeminal nerve, which is the largest of the 12 cranial nerves that supplies sensation to the face, mucous membranes, and other structures of the head. Triptans come in the forms of pills, nasal sprays, and injections.
Another acute medication for migraines is ergotamines (a.k.a. ergots). Ergots constrict the blood vessels and are not designed specifically for migraines, but doctors have used them for migraines since the 1930s. These are used less commonly now, but they may be prescribed to people who have not found relief using triptans.
The final acute medication commonly used for migraines are nonsteroidal anti-inflammatory medications, often called NSAIDs. These nonspecific pain relievers—such as aspirin and ibuprofen—are often found over-the-counter.
These NSAIDs are affordable and readily available, but they’re not the perfect solution: “You often need a decent dose in order to stop a migraine,” says Dr. Green. Using NSAIDs for migraines on a daily or regular basis could lead to medication overuse, and may even make your headaches worse.
The Natural Treatments You Shouldn’t Overlook
One of the best ways to treat your early migraine needs no prescription or trip to the pharmacy at all: Napping.
In addition to taking an acute medication that works best for you, simply sleeping may help treat your migraine. “Lie down and see if you can possibly fall asleep,” says Dr. Green. “Sleep is often very effective to abort an individual attack.”
Another natural treatment that can supplement your acute medications is caffeine. This one’s tricky, since caffeine can either trigger or treat migraines, depending on the person. (Consider that caffeine is actually an active ingredient in several pain relievers, including Excedrin and Midol.) Caffeine tends to be more effective at reducing migraine pain in people who are not already active caffeine consumers.
For more tips, learn more about natural home remedies that help treat migraines.
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And when you first have an attack,
00:00:04,830 --> 00:00:08,632
the worst thing that you can do is to
ignore it and think it's gonna go away.
00:00:08,632 --> 00:00:14,021
00:00:14,021 --> 00:00:17,501
When you first develop a migraine and
you have an acute medication,
00:00:17,501 --> 00:00:19,980
we want you to take it,
take it right away.
00:00:19,980 --> 00:00:23,210
Because what we've learned
is that the false alarm rate
00:00:23,210 --> 00:00:24,598
in early migraine is very low.
00:00:24,598 --> 00:00:28,040
Another is when people think,
I think I'm going to get a migraine.
00:00:28,040 --> 00:00:28,590
00:00:28,590 --> 00:00:29,830
They're gonna get a migraine.
00:00:29,830 --> 00:00:31,650
And the longer they wait to treat,
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the less likely it is to
respond to the treatment.
00:00:34,330 --> 00:00:37,635
The most common acute medications
we use are called triptans.
00:00:37,635 --> 00:00:41,767
And then there are a variety of
formulations of the different triptans,
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pills, nasal sprays, injections.
00:00:43,972 --> 00:00:48,197
They works based on turning off these
nerves called trigeminal nerves which
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are very important in
the pathology of a migraine.
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We still occasionally use ergots,
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we don't use them very much we
used to use them all the time,
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they are probably not as effective and
probably not as safe as a triptan.
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Anti-inflammatories are very important,
many of them over the counter,
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although you often need a decent
dose in order to stop the migraine.
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Migraines are inflammatory, so
it's certainly rational to think
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an anti-inflammatory could
help treat a migraine.
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Well, the thing that's most
likely to work in a patient
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to stop a migraine other
than medication is a nap.
00:01:20,018 --> 00:01:24,218
We'd like you to lay down, and
see if you can possibly fall asleep,
00:01:24,218 --> 00:01:28,890
because sleep is often very effective
to abort an individual attack.
00:01:28,890 --> 00:01:31,110
For people who are not big caffeine users,
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taking caffeine at that time
as well can be helpful.
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The real expert migraine
patients learn what the earliest
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symptoms of their attacks are, and
they learn to treat at that point.
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Caffeine and migraine. Mount Royal, NJ: American Migraine Foundation, 2017. (Accessed on August 16, 2018 at https://americanmigrainefoundation.org/understanding-migraine/caffeine-and-migraine/.)
Commonly used acute migraine treatments. Mount Royal, NJ: American Migraine Foundation, 2016. (Accessed on August 16, 2018 at https://americanmigrainefoundation.org/understanding-migraine/commonly-used-acute-migraine-treatments/.)
Identifying & treating migraine. Mount Royal, NJ: American Migraine Foundation, 2015. (Accessed on August 16, 2018 at https://americanmigrainefoundation.org/understanding-migraine/identifying-treating-migraine/.)
Pringsheim T, Becker WJ. Triptans for symptomatic treatment of migraine headache. BMJ. 2014;348:g2285.
Sleep. Mount Royal, NJ: American Migraine Foundation, 2016. (Accessed on August 16, 2018 at https://americanmigrainefoundation.org/understanding-migraine/sleep/.)