Which Migraine Medication Is Right for You?
There are some key questions to guide you and your doctor toward the right medication. Three things Yacoub likes to ask people with migraine are:
- Does your headache pain ramp up really quickly?
- Do you get nausea early during an attack?
- Do you often wake up with a headache?
If people answer yes to any of those things, Yacoub says shots and nasal sprays tend to be a good first choice. That’s because these non-oral forms get migraine medication into your bloodstream faster than a pill and bypass your gut.
But the right migraine medication for you depends on several things. Some topics to bring up with your doctor are:
- If your headache pain builds slow or fast
- If you have headaches that last a long time
- Whether you’d rather take a pill
- Your age and other health conditions
You’ll also want to tell your doctor about any medication you’ve tried before that hasn’t worked.
When to Change Your Migraine Medication
In general, acute treatment shouldn’t be used more than two or three times a week. One worry is something called medication overuse headache. That’s the idea that symptom-relieving drugs may cause more headaches over time.
There’s no strong evidence that all migraine-specific drugs lead to medication overuse headache. In fact, gepants are a type of acute treatment that can also be used as preventive therapy. But according to Gottschalk, the main concern isn’t that taking too much of these will bring on more migraine attacks down the road.
“The conversation really should be that if you consistently have to treat your headaches more than three times a week, apparently we’ll need to do more,” he says.
Talk to your doctor about different acute treatment or preventive therapy if you have:
- More than four headaches a month
- Eight or more headache days a month
- Headaches that are debilitating
- A poor response to your current abortive drugs
Good migraine prevention should not only make your migraine attacks less frequent, but also make your headaches less severe. Preventive therapy may also boost your response to abortive drugs when you do need them.
