Migraine medication: what works now and what prevents attacks

Migraine medicine can change your life — if you pick the right option and use it the right way. The basic split is simple: acute meds stop an attack, preventive meds reduce how often attacks happen. Below I’ll walk you through common choices, safety flags, and quick tips to get better results from the drugs you use.

Acute treatments: stop the pain early

For a lot of people, fast action wins. Over-the-counter pain relievers like ibuprofen or naproxen help mild-to-moderate attacks. If OTCs don’t cut it, triptans (sumatriptan, rizatriptan, eletriptan and similar) are the main next step — they target migraine mechanisms and work best when taken early in the attack. Newer acute options include gepants (rimegepant, ubrogepant) and the ditan lasmiditan; they can help if triptans aren’t right for you or cause side effects. Antiemetics (metoclopramide or prochlorperazine) can reduce nausea and improve absorption of oral meds.

One practical tip: treat at the first sign of a real migraine, not when the pain is already raging. If one medicine doesn’t work, don’t stack a bunch of different pills without checking with your prescriber.

Preventive options and when to start them

If migraines happen regularly (for example four or more bad days a month), preventive therapy is worth discussing. Traditional preventives include beta-blockers (propranolol), antiepileptics (topiramate), and tricyclic antidepressants (amitriptyline). For people who don’t respond or who have frequent disabling attacks, newer targeted options are CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab) and small oral CGRP blockers. Botox injections can help chronic migraine sufferers. Your doctor will pick based on your other health conditions, side effects, and cost.

Watch out for medication-overuse headache: using triptans, opioids, or combination pain killers on 10 or more days a month — or simple painkillers on 15+ days — can make headaches worse over time. If that sounds like you, talk to your clinician about tapering and a preventive strategy.

Side effects and safety checks matter. Tell your provider about heart disease, high blood pressure, pregnancy or plans to get pregnant. Many migraine drugs interact with other medicines, so bring a full list of what you take. If you buy meds online, use a licensed pharmacy, require a prescription, and verify contact details and reviews — avoid sites that sell prescription drugs without asking for a script.

Final practical moves: track attacks and triggers in a simple app or notebook, treat early, keep a written rescue plan from your provider, and get help if headaches are changing, suddenly worse, or don’t respond to usual treatment. With the right meds and a sensible plan, most people can cut migraine frequency and reclaim normal days.