What is migraine headache?

Migraines are painful, throbbing headaches that often start on one side of the head. They may cause nausea and vomiting and make you sensitive to light, sound, or smell.

Without treatment, migraines can last from 4 hours to a few days. Medicines can help prevent migraines or stop them after they have started. Your doctor can help you find which ones work best for you.

Migraines sometimes start with an aura of spots, wavy lines, or flashing lights about 30 minutes before the headache begins. Without treatment, a migraine headache can last from 4 to 72 hours. Muscle aches or feeling very tired may last for up to a day after the migraine ends.

You can't cure migraines. But you can use medicines and other treatments to feel better. Finding and avoiding the things that trigger your headaches may also help.

The goal of treatment is to reduce how often you get migraines and to stop the headaches with the fewest drug side effects.

For mild to moderate migraines, you may first want to try over-the-counter pain relievers. They have fewer side effects. And they cost less than other medicines. But if they don't help, you may need prescription medicines.

Your doctor may prescribe medicines to stop or to prevent a migraine.

If treatment doesn't help your migraines, you and your doctor may make changes. You may try different medicines, a new mix of medicines, or different doses. Sometimes, treatments that don't use medicines are tried. It may take some time to find the right treatment to help you.

To help prevent migraine headaches:

• Avoid things that trigger your migraines, such as certain foods.
• Find healthy ways to cope with stress.
• Get regular exercise.
• Keep a regular schedule for sleeping and eating.
• Take medicine that prevents migraines, if your doctor prescribed it.

To diagnose migraines, your doctor will ask about your personal and family history and examine you. Your doctor will ask how many headaches you have, how long they last, and what symptoms you have. You may get tests if your doctor thinks your symptoms may be caused by another disease.

Two kinds of medicines are used to treat migraines. There are medicines to stop a migraine and medicines to prevent migraines.

Finding the right mix of medicines for you may take some time. So work closely with your doctor to try different medicines and doses. In most cases, your doctor will first prescribe a medicine that causes the fewest side effects. Medicines may be prescribed based on your type of migraine.

Medicines can help you feel better. But they can also be dangerous, especially if you don't take them the right way. Be safe with medicines. Take them as prescribed by your doctor. Read and follow all instructions on the label.

Medicines to stop a migraine

These are sometimes called abortive medicines. They may be over-the-counter or prescription medicines. If you take the medicine at the first sign you're getting a migraine, you may stop the headache before it starts.

If your migraines are mild to moderate, you may need only an over-the-counter medicine to stop the pain. Most doctors recommend that you try these medicines first. That's because they may have fewer side effects than prescription medicines. But if they don't stop your headaches, your doctor may prescribe other medicine.

Your doctor may suggest that you take a mix of medicines to stop a headache. For example, you may take acetaminophen or naproxen along with a prescription medicine, such as a triptan.

Medicines used to stop a migraine include:

• Over-the-counter medicines. Examples include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Some over-the-counter medicines combine acetaminophen, aspirin, and caffeine.
• Triptans (serotonin receptor agonists). Examples are sumatriptan and zolmitriptan.
• Ergotamine derivatives. An example is dihydroergotamine.

Medicines such as ubrogepant may be tried if you can't take other medicines or the medicines did not work.

Talk to your doctor if you are taking medicine more than 2 days a week to stop a headache. Taking too much pain medicine can lead to more headaches. These are called medicine-overuse headaches.

If you have nausea or vomiting during migraine attacks, your doctor also may prescribe medicine to help with these symptoms.

Medicines to prevent a migraine

These medicines are often called preventive medicines. You get most of them with a prescription, but some over-the-counter herbs and supplements may be tried too. You take these every day or whenever your doctor tells you to.

Medicines used to prevent migraines include:

• Anticonvulsants, such as topiramate.
• Antidepressants, such as amitriptyline.
• Beta-blockers, such as propranolol.
• CGRP antagonists, such as erenumab.
• Botulinum toxin, such as Botox. This is used for prevention if you have chronic migraines.

You may want to try medicine to prevent a headache if:

• You use medicines to stop headaches more than twice a week.
• Medicines to stop migraines aren't working well for you.
• You have four or more headaches a month that keep you from doing your daily activities.
• You have menstrual migraines.
• You have uncommon migraine symptoms. These may include a long period with aura or numbness during your headache.

Medicines to prevent migraines may cause side effects. Some of these side effects may last for as long as you take the medicine. Or they may go away within a few weeks. You may need to decide which bothers you more—the side effects of the medicine or your migraines.

Medicines may not prevent every migraine. So you may still need to take another kind of medicine that can stop a migraine after it has started. But prevention medicines can reduce how many migraines you get, reduce how long they last, and make your symptoms less severe.

You may be more likely to get migraines if you have a family history of migraines. Females are more likely to get migraines than males. You may also be at higher risk if you are a teenager or young adult. Migraines often start during these years but may peak in your 30s.

Triggers are things that can cause a migraine headache to start. They are different for each person. Triggers can be foods, hormones, changes in daily routine, medicines, lights, odors, and other things in the environment.

Common migraine triggers include:

• Stress. (It can trigger a headache during the stressful time or right after the stress is relieved).
• Menstrual cycle.
• Changes in your routine, such as how much you exercise or sleep.
• Fasting or skipping meals.
• Changes in the weather, or heat or high humidity.
• Bright lights, glare, or reflected sunlight.
• Certain foods, such as foods with nitrates, like hot dogs, bacon, and cold cuts.
• Alcohol—all alcohol, or one type in particular, like beer or red wine.
• Strong odors such as perfume, paint, dust, or certain flowers.
• Sleeping more or less than you usually do.
• Aspartame.

To find your triggers:

• Use a headache diary to keep track of what you do each day. Write down what you eat and drink, the stress you feel, the weather, and other things.
• Pay attention to your daily routines, like how much exercise and sleep you get.

You may start to see patterns to what triggers your headaches. Then you can make changes to avoid or manage those triggers.

Experts aren't sure what causes migraines. They believe that changes in the activity of brain cells may lead to inflammation in certain nerves, which causes pain. Migraines often run in families, so genetics may play a role for some people. Some things, called triggers, can cause a migraine to start.

Migraines are painful, throbbing headaches that last from 4 to 72 hours. When you have a migraine, it may be so painful that you aren't able to do your usual activities. But migraines can be treated. And even though they make you feel bad, they don't cause long-term damage.