Migraine medication: how to stop attacks and prevent them

One bad migraine can ruin your whole day. The good news: you don’t have to guess which medicine to try first. This page breaks down proven options for quick relief, long‑term prevention, and simple tips to avoid making headaches worse.

Acute treatments — stop a migraine fast

When a migraine starts, act fast. Over‑the‑counter choices that work for many people are ibuprofen, naproxen, or acetaminophen. Excedrin (aspirin + acetaminophen + caffeine) helps some folks if taken early. If OTCs fail, prescription options include triptans — common names are sumatriptan, rizatriptan, and eletriptan. Triptans work by narrowing blood vessels and blocking pain pathways; they often cut an attack within 2 hours.

Newer options for acute attacks include the gepants (ubrogepant, rimegepant) and lasmiditan (Reyvow). Gepants are pills you can use even if triptans don’t help or aren’t safe. Lasmiditan works differently and can cause drowsiness and dizziness, so don’t drive for 8 hours after taking it.

Don’t forget anti‑nausea meds like metoclopramide or prochlorperazine if vomiting or stomach upset keeps you from holding pills down. If you use a nasal spray or injection (sumatriptan options), they can help when oral meds can’t be kept down.

Prevention and smarter long‑term choices

If you have 4 or more bad migraine days per month, or attacks that don’t respond to acute drugs, consider preventive therapy. Classical preventives include beta‑blockers (propranolol), certain antidepressants (amitriptyline), and anticonvulsants (topiramate). They lower attack frequency but need a few weeks to work.

Modern migraine‑specific preventives target the CGRP pathway: injectable monoclonal antibodies like erenumab, fremanezumab, galcanezumab, and eptinezumab, and the oral atogepant. These often cut monthly migraine days significantly for people who tried other drugs first. Insurance often requires prior authorization, so expect paperwork and possible step therapy.

Botox injections are another option for chronic migraine (15+ headache days/month with 8+ migraine days). They’re given every 12 weeks and work well for some people.

Important safety notes: avoid triptans if you have uncontrolled high blood pressure or certain heart conditions. Using acute meds more than 10–15 days per month can cause medication‑overuse headache. Many migraine drugs aren’t safe in pregnancy — always talk to your clinician if you’re pregnant or planning to be.

Quick practical tips: take acute meds at the first sign of migraine, pair them with an anti‑nausea drug if needed, track your attacks in an app, and talk to your doctor about prevention if attacks are frequent or disabling. If your headache is suddenly the worst ever, comes with weakness, slurred speech, fever, or neck stiffness, seek emergency care.

You don’t have to live with frequent migraines. With the right mix of fast relief, prevention, and simple habits, most people get noticeable improvement. Ask your clinician about options that match your health, lifestyle, and budget.