Health Education

When to talk to your doctor about a prescription for migraines

By | June 17, 2019

Throbbing, pulsing pain. Sensitivity to light and sound. Nausea and vomiting. If you are one of the 38 million Americans who suffer from migraines, you recognize these symptoms.

Scientific studies estimate that between 10 and 13 percent of people worldwide suffer from migraines. In fact, nearly 5 million Americans experience at least one migraine per month, and more than 11 million say that migraines cause a moderate to severe disability.

But the numbers vary greatly by age and sex. Women are three times as likely as men to have migraines. About 20 percent of women in the U.S. and 9.7 percent of men have experienced a migraine in the past three months according to one study by the U.S. Centers for Disease Control and Prevention (CDC). And reports of recent migraine pain reduced with age. For example, 24.7 percent of women aged 18–44 years old reported having experienced a migraine in the last three months. But among women aged 75 and older, the proportion of recent migraine sufferers was only 6.3 percent.

So what’s a migraine sufferer to do? If your massive headaches are frequent, it may be time to seek professional help.

Treatment for Migraines

When you have an ordinary headache, you might reach for an over-the-counter pain reliever such as aspirin, Tylenol, or Advil. Or you might simply drink some water and lie down for a bit. Often, this is not enough to knock out a migraine.

While there is no cure for migraines, there are two effective approaches to migraine treatment with medications, according to the National Institute of Neurologic Disorders and Stroke at the National Institutes of Health. The first approach is prevention of migraine attacks, and the second is relief of migraine symptoms once an attack has occurred.

NINDS reports that preventive treatment involves the use of drugs as well as behavior changes. People who experience frequent migraines should practice stress management techniques, such as exercise, meditation, biofeedback, and other methods of relaxation.

According to Dr. Mahan Chehrenama, a neurologist and migraine specialist in McLean, Virginia, patients should consider preventive medications if their migraine attacks are frequent (more than 4-6 per month) or severely disabling. “Preventive medications are generally prescription based, except for certain supplements like magnesium oxide,” she says. “These preventative drugs might also help patients better respond to pain relieving medications if a migraine does occur.”

Almost every patient who seeks medical care for migraines will need an “abortive” prescription medication. (These are medications that are taken at the onset of migraines to “abort” or stop a migraine attack.)

“Most patients who seek medical care regarding their headaches have been unsuccessful in treating them effectively with over the counter non-prescription analgesics,” Dr. Chehrenama says. So if you’ve gone through your pharmacy’s selection of OTC pain pills and your headache still won’t budge, it’s probably time to ask your doctor for a prescription.

Some abortive drugs are migraine-specific, like Triptans. Triptans are a class of drugs that currently includes seven different FDA-approved medications. These are Axert, Relpax, Frova, Amerge, Maxlt, Imitrex, and Zomig. But your doctor might choose to prescribe non-migraine specific abortive meds, like nonsteroidal anti-inflammatory drugs (Nsaids).

“If a patient suffers from nausea or vomiting [during migraines], they are less likely to absorb oral meds effectively and commonly will require non-oral formulations of migraine abortive, such as a nasal spray or a subcutaneous injection,” Dr. Chehrenama says.

So if you are one of the millions of people in the U.S. suffering from migraines, talk to your doctor about treatment options.