Migraine Therapy: The Acute Attack

For a typical migraine headache, using pain medication early and at a sufficiently high dose has a decisive effect on how well it works. Options include classic painkillers such as aspirin, ibuprofen, metamizole, and paracetamol, or migraine-specific medication — the so-called triptans, which have the advantage of also being available as melt tablets, nasal sprays, or injections.

Classic pain medication should always be taken in a fast-dissolving form. Combining it with 10mg of MCP or domperidone is also worthwhile — this treats nausea while also improving absorption of the pain medication through the gut. For very severe attacks, or ones lasting more than three days, infusion therapy may be an option in-clinic.

Pain medication should be taken on no more than 10 days per month — taking it more often raises the risk of medication-overuse headache.