8 Things to know before selecting drug of choice for Migraine

selecting drug of choice for Migraine

Unsettling migraine attacks can ruin your productive day. Those suffering from chronic attacks are aware of the unpredictable nature of migraines which at times are difficult to treat. Since no two attacks are same, what would be the drug of choice for migraine? There can be no definite answer to this.

You can maintain an arsenal of medicines and also opt for Ayurvedic and home remedies to find the best relief. Many a time, a doctor might suggest a preventive medicine to avoid recurrence or even if it occurs, it would be of less severity.

The symptoms of migraine are different in different people. You may need more than one type of treatment to tackle it. If you have any other physical problems, the conventional drug choice for migraine may not be applicable. Let us have an understanding of different drugs and their action in treating different types of migraines.

1.     Understanding the common drugs for migraine:

Opioids Typically, a person suffering from acute migraine pain prefers over-the-counter NSAIDs like aspirin, ibuprofen, acetaminophen or naproxen. Certain prescription medicines include triptans which are meant to address a specific migraine attack.

Ergotamine can be self-administered if triptans do not work and you badly need relief from the throbbing pain. Those with heart ailments should avoid triptans and ergotamines. Opioids like Vicodin or Percocet and barbiturates like Fioricet and Fiorinal are prescribed for those suffering from acute migraine.

Normally, narcotic drugs are not prescribed as the first line of treatment for migraine considering its possible side effects.

2.     Preventive medicine for migraine:

This could be the drug of choice for migraine as these medicines lower the chances of an attack. These are CGRP inhibitors, a new class of drugs that inhibit the function of CGRP (calcitonin gene-related peptide) molecule responsible for migraine pain.

The specially approved drug of this class is Erenumab (Aimovig) and fremanezumab (Ajovy). One injection a month can result in fewer migraine attacks although side effects like mild pain and redness at the injection area cannot be ruled out.

3.     Drugs for hypertension and heart disease:

brain-cellsBeta-blockers prescribed for treating high blood pressure are often applied to treat migraine. These medications like Atenolol, Metoprolol, Nadolol, Propranolol and Timolol etc. are known to slow down the action of brain cells related to migraine pain.

Nearly 4 out of 5 people taking beta blockers are known to get the desired relief. These naturally become their drug of choice for migraine. Like any other medication, these are accompanied by side effects like experiencing problems in sex or feeling depressed.

People with chronic asthma and diabetes are not given beta-blockers. Doctors will prescribe a different type of medication for those experiencing migraine with auras. For them, Verapamil, a common drug for heart disease, is often a better drug of choice for migraine.

4.     Antidepressants as the drug of choice for migraine:

It is not necessary antidepressants are meant only to treat depression. It can be a good option for treating migraine too. Tricyclic antidepressants or TCAs (Amitriptyline or Nortriptyline) have the capability to alter the reaction path of certain brain chemicals triggering a migraine attack.

People taking these medicines may experience weight gain and fatigue. These may initiate serious problems for heart patients and pregnant women. Depression in kids and young adults may worsen with antidepressants.

5.     Botulinum Toxin (Botox):


A well-known treatment for wrinkles, this nerve toxin is also known to stave off migraine attacks by blocking the onset of pain network in the brain. This treatment is only approved for those having migraine attacks at least 15 days a month.

More frequent the migraine attacks better is the action of Botox on it. But you may have to go through several sessions before you feel its effects.

6.     Anti-seizure medicines:

Anti-seizure drugs like Divalproex Sodium and Topiramate reduce migraine attacks by blocking the pain signals of the brain. You may feel sleepy and face difficulty in concentrating. These drugs should not be taken during pregnancy or in case of liver problem and pancreatitis.

7.     Home remedies:

It is not a bad idea to combine natural treatments along with taking your drug of choice for migraine for better outcomes. Some of the effective home remedies for migraine are listed below:

1.      Drink ginger tea:


Brew tea from raw ginger slices and have 2-3 times a day. It has the ability to block the action of prostaglandins contributing to muscle stimulation and headache.

2.      Inhale essential oils:

Oils of rosemary, lavender and jasmine soothe your nerves and eliminate the triggers of migraine. Rosemary oil helps in normalizing hormonal imbalances responsible for migraine in women. In a pail of hot water, add 10 drops of any essential oil and inhale for 10-15 minutes.

3.      Use peppermint:


4.      Apply Nutmeg paste:

Nutmeg calms your nerves and induces sleep. Make a paste of crushed nutmeg and water and apply over your forehead. You will get instant relief.

The anti-inflammatory property of peppermint works well in combating migraine attacks. Brew tea from peppermint leaves and drink 2-3 times a day. Massage your temples with peppermint oil and leave it for 30 minutes. You will feel better.

5.      Inhale saffron:

saffronMake a paste of saffron and pure ghee and add a few drops of it into your nostrils. Inhale for 5-10 minutes. You will get amazing results.

6.      Apply sesame oil:

Often, dry nature of your body stiffens muscles triggering a migraine attack. Put a few drops of sesame oil in your nasal passage several times a day to reduce the pressure created by muscle stiffness. Your migraine will subside slowly.

8.     Ayurvedic medicine:

Ayurveda offers you ample choices for migraine treatment which are no less effective than medications. The following Ayurvedic medicines can help you find an effective solution:

1.      Shirodhara:

medicinal plant

A process of streaming a thin or thick liquid made of medicinal plants and natural ingredients over the forehead and scalp for a specified time.

2.      Ayurvedic herbs:

A number of herbs like mallika, amlaki, sariva, haritaki, jashtimadhu, balakumari etc. provide complete relief from migraine pain. These herbs are either used singly or blended in a mixture to address different types of migraine pain.

3.      Medication:

Ayurvedic medicineYou can also get your drug of choice for migraine in Ayurvedic medicine. Chandrakala rasa, Kamadugha rasa, Bhoonimbadi Kara, Godnati Bhasma, Pathyadi Kada, Shirashooladi vajra rasa are some of the effective medications for migraine.

4.      Shirolepa:

An application of paste made of choicest herbs like sandalwood, jatamansi etc. along with camphor.

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