Medications for Migraine Headaches

Medications have long been an excellent and popular option in curing migraine headaches. Neurologists, pain management physicians, and other medical specialists have successfully prescribed medication to migraine headache patients over the years.

However, many patients find that migraine medications do not provide adequate relief, with some even producing intolerable side effects. In these specialized cases, our surgeon Dr. Lowenstein would evaluate their suitability for migraine surgery, providing long-term, medication-free migraine headache relief. However, even in cases where surgery is an option, our surgeon Dr. Lowenstein strongly urges his patients to follow up with their medical specialist to confirm that they have exhausted all possibilities with medication.

Migraine Medication Classifications

Migraine medications can be classified into two types: medicines that prevent the onset of a headache (Preventive) and medicines that aim to stop a headache once symptoms begin (Abortive).

Medications such as ergots and triptans are used to stop migraine headache symptoms once they have started. Meanwhile, other drugs such as antidepressants, anti-seizure drugs, and blood pressure medications can be used to prevent headaches from starting.

Recent migraine medications such as Emgality, Aimovig, and Ajovy targets specific pain chemicals in the brain. However, these medications often have variable success in providing improvement in migraine pain. Success rates of these medications are usually lower than migraine surgery, and most patients who stop these medications do so because of their side effects or expense, which over time can eclipse the costs associated with migraine surgery.

Medications for Migraine Pain Relief

Pain relievers

These are over the counter or prescription pain relievers which include ibuprofen and aspirin. While pain relievers may work for some, they can cause gastrointestinal issues in the long run. These and other medications can also cause rebound headaches, also known as medication induced headaches.


Examples of triptans are Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, and Zomig. These prescription drugs block specific pain pathways in the brain and can be taken as pills, shots, or nasal sprays.


These medications are most effective when taken shortly after the start of symptoms, and they are suitable for migraines that last longer than 24 hours. Like triptans, they can also be taken as nasal sprays or injections. Examples of dihydroergotamines are D.H.E 45 or Migranal.


Also known as Reyvow, this medication option is relatively new. Reyvow is an oral tablet that has been proven to improve pain and nausea significantly.

CRGP antagonists

CRGP is a new type of medication that blocks the calcitonin gene-related peptide (CGRP) protein that causes pain transmission. Examples of CRGP antagonists are Aimovig, Ajovy, Emgality, Byepti, Ubrelvy, and Nurtec ODT.


Opioids are only used if all other treatments have been unsuccessful, as they are highly addictive. Most opioids are only available through prescription, and they may range from lower strength opioids such as Panadeine or high strength ones such as tramadol. Opioids should be avoided in all but the most severe situations as they not only have addictive properties but also terrible side effects as well as causing rebound headache pain.

Anti-nausea drugs

If a migraine is accompanied by nausea and vomiting, anti-nausea drugs such as chlorpromazine, metoclopramide, or prochlorperazine help ease the symptoms. Most patients take these anti-nausea drugs with painkillers.

Medications to Prevent Migraines

Neurologists may use certain drugs for patients with frequent, long-lasting, or severe headaches. These prescription medications seek to reduce how often the person gets a migraine, its severity, and its duration.

Blood pressure-lowering medications

Beta-blockers and calcium channel blockers can help prevent classic migraines.


Antidepressants such as Tricyclics have also been proven effective in preventing migraines in several patients.

Anti-seizure drugs

Drugs such as Valproate and topiramate have been shown to decrease the frequency of migraines.


Injections of the Botox every 12 weeks is another method used to prevent migraines in some patients.

Calcitonin gene-related peptide monoclonal antibodies

A new class of drugs approved by the FDA, these medications are administered monthly via injection to treat migraines.

Narcotic & Opioid Medication for Migraines

While narcotics and opioids can treat migraines, these medications are addictive and can cause hospitalizations and even deaths. The department of Health and Human Services estimates that in 2014, the economic impact of the opioid epidemic was 55 billion dollars.

One of the main advantages of migraine headache surgery is the ability to cut down, if not wholly eliminate, the use of addictive medications. If you are looking for a more permanent solution to your migraine headaches, please contact us at or call us at 805-969-9004.


Who can prescribe migraine medications?

A primary care doctor or neurologist can prescribe migraine medications, however, a neurologist is going to be the best resource as an expert in the medical treatment of headache pain. They will discuss the various medications currently available during your visit, including their benefits and side effects. Our surgeon Dr. Lowenstein does not prescribe migraine medications to patients.

Is it safe to switch migraine medications?

Switching medications should only be done after discussions with your neurologist, as they would know the potential side effects of the medication and provide advice on how to switch medications safely.

Are there any risks in taking migraine medications?

All medications have potential side effects. Again, we’d advise you to speak to your neurologist and read the leaflet that’s usually included in your medicine.

What if my migraine medication is ineffective?

When medications prove ineffective for migraines, then migraine surgery might be the best option. Migraine headache surgery is an effective, long-term solution for chronic migraine headaches, tension headaches and chronic headaches that don’t respond to medication. Our experienced surgeon Dr. Lowenstein will use nerve blocks during your consultation to determine if you are a good candidate for migraine surgery. He will also discuss possible long-term options with you if medications are not working.

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