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Medications
Headache medications can be grouped into three different categories: those that provide symptomatic relief, abortive therapy (intended to stop the process that results in a headache), and preventive therapy. Each type of medication is most effective when used in combination with management techniques such as dietary and lifestyle changes, exercise, and relaxation therapy.
Medications that promise symptomatic relief address the headache pain or the nausea and vomiting associated with migraine. These may include simple analgesics, ibuprofen or acetaminophen, antiemetics or sedatives. Many of these are available over-the-counter, while others require a prescription.
Important: If symptomatic relief medications are used frequently for headaches that are severe enough to interfere with functioning, you should consult your healthcare provider about preventive headache medications. Overuse of symptomatic medications can actually cause more frequent headaches or worsen headache symptoms.
Abortive therapy is most effective when used at the first sign of a migraine to stop the process that causes the headache pain. These drugs may also be given for cluster headaches. Abortive medications include: triptans such as sumatriptan succinate (Imitrex) and zolmitriptan (Zomig), dihydro-ergotamine mesylate (DHE-45, Migranal), a combination medication (Midrin), and ergotamine tartrate and caffeine (Cafergot).
Preventive therapy is used to treat very frequent tension headaches and migraines, the combination of both types of headaches, and cluster headaches. Most of these medications require a prescription. Drugs are aimed at reducing both the frequency and severity of the headaches and include:
- nonsteroidal anti-inflammatory (NSAID) medications
- antidepressants
- antihistamines such as cyproheptadine
- beta blockers
- calcium channel blockers
- anticonvulsant medications
- lithium
Many combination headache medications include caffeine, which can make other medications more effective.
Pregnant women are advised to avoid any medication due to its potential effect on the fetus, although a mild analgesic for pain, such as acetaminophen (Tylenol), can be safely used. A woman who suffers from headaches during her pregnancy should discuss other treatment options with her obstetrician.
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