Migraine and severe migraine: what are your treatment options?

While migraine and severe migraine both refer to the same underlying neurological disorder, the key difference lies in the intensity, frequency, and impact of the attacks. While regular

migraine symptoms can often be managed with conventional treatments and may not significantly disrupt daily life, severe migraine symptoms are more intense and may require more specialized

treatments. Treating migraine To alleviate symptoms during an active migraine attack, several treatment options are used: * PAIN RELIEVERS: Over-the-counter (OTC) pain relievers like

ibuprofen, aspirin, Excedrin, and acetaminophen can relieve mild to moderate migraine pain. * TRIPTANS: For more severe migraine pain, stronger prescription medications such as triptans

(e.g., sumatriptan, rizatriptan) are often used. Triptans help constrict blood vessels and block pain pathways in the brain, providing relief when taken early. * FIORICET: This is a

combination medication that helps relieve migraine symptoms by reducing pain, inflammation, and muscle tension, typically through its active ingredients acetaminophen, butalbital, and

caffeine. * ANTI-NAUSEA MEDICATIONS: Many migraine sufferers experience nausea and vomiting. Metoclopramide and prochlorperazine are commonly prescribed to alleviate these symptoms, helping

patients keep oral medications down and improving overall comfort. * ERGOTAMINES: Medications like dihydroergotamine (DHE), available in nasal spray or injection form, are sometimes used

when triptans are ineffective. Ergotamines constrict blood vessels and can provide relief from severe attacks. * CORTICOSTEROIDS: In cases where migraine is resistant to treatment,

short-term use of steroids like prednisone can reduce inflammation and provide relief. Keep in mind that sometimes severe migraine pain responds well and quickly to OTC treatment. Sometimes

people with very mild migraine symptoms do not improve with OTC treatments and need to take triptans or CGRP antagonists for relief. Preventive treatments for migraine Preventive treatments

are also available to reduce the frequency and intensity of migraine and include: * beta-blockers like propranolol * anticonvulsants like topiramate and valproate (These are commonly

prescribed to help reduce the frequency of attacks.) * CGRP Inhibitors like erenumab and fremanezumab (This newer class of drugs works by blocking the protein calcitonin gene-related peptide

(CGRP), which plays a key role in triggering migraine episodes.) * Botox to help reduce the number of migraine days (Botulinum toxin injections are FDA-approved for chronic migraine

prevention.) Treating severe migraine Severe migraine episodes, characterized by intense, debilitating pain that may last for days, often require more intensive treatment strategies. These

migraine episodes often do not respond to OTC medications and can significantly disrupt daily life. The goal of treatment is to alleviate the acute pain, manage symptoms like nausea, and

prevent future attacks. To help reduce symptoms of severe migraine, many treatments are the same for mild to moderate migraine — it’s a matter of how an individual person responds to the

treatment. IV medications are a treatment for severe migraines. In emergency or hospital settings, intravenous (IV) treatments may be used. Medications like anti-nausea drugs (e.g.,

metoclopramide) and pain relievers (e.g., morphine or NSAIDs) can be administered directly into the bloodstream for faster and more effective relief. The takeaway Treating migraine and

severe migraine requires a personalized approach that includes both acute interventions for immediate relief and preventive strategies to reduce frequency and intensity. A comprehensive

treatment plan, created by working with your healthcare professional, is essential for improving quality of life and minimizing the impact of migraine on daily functioning.