{"id":630316,"date":"2024-11-07T19:44:51","date_gmt":"2024-11-08T00:44:51","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630316"},"modified":"2025-06-03T14:37:27","modified_gmt":"2025-06-03T18:37:27","slug":"prednisone-for-migraine","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/prednisone-for-migraine\/","title":{"rendered":"Is prednisone good for migraines?"},"content":{"rendered":"

Prednisone<\/span><\/a> (and <\/span>dexamethasone<\/span>) are <\/span>corticosteroids<\/span><\/a> that treat conditions such as allergies, inflammation, asthma, and much more. They\u2019re prescription drugs that work by reducing swelling and symptoms caused by immune system reactions.\u00a0<\/span><\/p>\n

Since <\/span>inflammation can also contribute to <\/span>episodic migraines<\/span>, and the <\/span>treatment of acute migraines<\/span><\/a> often entails anti-inflammatory drugs, could <\/span>prednisone<\/span> be used to treat cephalgia (or <\/span>head pain<\/span>), too?<\/span><\/p>\n

Healthcare<\/span> professionals don\u2019t typically prescribe <\/span>prednisone<\/span> for the <\/span>39 million Americans who get <\/span>migraine attacks<\/span><\/a>, but they will in some situations.<\/span><\/p>\n

Can <\/span>prednisone<\/span> be used for migraines?<\/span><\/h2>\n

Usually, other medications are used for migraine treatment. \u201cCurrent practice recommendations do not recommend the routine use of <\/span>prednisone<\/span>, a <\/span>corticosteroid<\/span>, in the acute treatment of migraines,\u201d says <\/span>Luke Hentrich, Pharm.D., BCPS<\/span><\/a>, an assistant professor who answered the questions in conjunction with <\/span>Hannah Suber, a Pharm.D. candidate<\/span><\/a>, both at the University of Tennessee\u2019s Health Science Center College of Pharmacy.\u00a0<\/span><\/p>\n

However, <\/span>prednisone<\/span><\/a> is sometimes used to treat migraines. Dr. Hentrich says the body of literature for using <\/span>corticosteroids<\/span> to treat migraines has been found to be beneficial in treating \u201cstatus migrainosus,\u201d or over-seven-day-long \u201c<\/span>severe migraines<\/span> that persist despite the appropriate use of over-the-counter and prescription medications, and those who have a history of recurrent <\/span>migraine headaches<\/span>.\u201d<\/span><\/p>\n

It can be taken alone or in conjunction with another medication. \u201c<\/span>Prednisone<\/span> is quite efficient by itself or as adjunct to other migraine medication in treating recurring moderate to <\/span>severe migraines<\/span> called status migrainosus, and also certain types of headaches,\u201d agrees <\/span>Hany Demian<\/a>, MD<\/span>, a pain management healthcare provider and CEO of <\/span>BioSpine Institute<\/span><\/a>.\u00a0<\/span><\/p>\n

An<\/span>\u00a0article in <\/span>Evidence-Based Practice<\/span><\/i><\/a> suggests this, too. It says adding a steroid to standard abortive therapy reduced the rate of moderate or severe recurrence of migraines within 72 hours of treatment by about 30% compared to the <\/span>placebo group<\/span>.<\/span><\/p>\n

The way a patient consumes the steroid may also matter. A <\/span>retrospective study<\/span><\/a> in <\/span>Headache: The Journal of Head and Face Pain<\/span><\/i> found that both oral steroids and <\/span>intravenous<\/span> injection steroids can serve as a <\/span>short-term<\/span> treatment for <\/span>cluster headaches<\/span>, but the former might be more effective. The researchers noted that a <\/span>randomized<\/span> trial is a warranted next step, though.<\/span><\/p>\n

Another option for treating <\/span>cluster headaches<\/span> is <\/span>dihydroergotamine<\/span><\/a>, an acute migraine medication. Why might one medication be prescribed over another?\u00a0<\/span><\/p>\n

Dr. Hentrich says <\/span>healthcare<\/span> providers prescribe <\/span>prednisone<\/span> \u201cif a patient is unable to take common medications prescribed for acute migraine treatment.\u201d He gives the examples of a person with a kidney condition being unable to take <\/span>ibuprofen<\/span>, or <\/span>sumatriptan<\/span> due to a previous heart attack, or rimegepant due to insurance coverage.\u00a0<\/span><\/p>\n

\u201cThey may also prescribe <\/span>prednisone<\/span> if the migraine has persisted for a long period, or for migraines that persist from overuse of other acute treatments, known as <\/span>medication overuse<\/span> headache,\u201d Dr. Hentrich adds.<\/span><\/p>\n

According to Dr. Demian, <\/span>triptans<\/span> are most often prescribed to kill <\/span>migraine headaches<\/span>, and they\u2019re taken as soon as the migraine begins. He adds that nasal sprays are faster-acting <\/span>triptans<\/span>.<\/span><\/p>\n

The former is true in Dr. Hentrich\u2019s practice; he specifies that <\/span>sumatriptan<\/span> (as an oral tablet, nasal spray, nasal powder, or subcutaneous injection) is most commonly prescribed\u2014but again, that option can be dangerous for people who have had a heart attack.<\/span><\/p>\n

As far as <\/span>prophylactic<\/span> measures or <\/span>migraine prevention<\/span>, Botox is a common go-to, Dr. Demian says.<\/span><\/p>\n

How does <\/span>prednisone<\/span> work for migraines?<\/span><\/h2>\n

Since <\/span>prednisone<\/span> isn\u2019t currently recommended outright, the mechanisms behind its helpfulness for migraines are unclear, according to Dr. Hentrich. But, according to him and Dr. Demian, the reasoning probably goes back to inflammation.<\/span><\/p>\n

\u201c<\/span>Prednisone<\/span> or <\/span>corticosteroids<\/span> can readily cross the blood-brain barrier and reduce neurogenic inflammation, hence reducing the recurrence of <\/span>headaches<\/span><\/a>,\u201d Dr. Demian explains.<\/span><\/p>\n

How long does it take <\/span>prednisone<\/span> to work for migraines?<\/span><\/h2>\n

While there’s no definitive evidence around how quickly a person may feel <\/span>prednisone<\/span>\u2019s benefits during a migraine, Dr. Hentrich says available pharmacokinetic information suggests around two hours.<\/span><\/p>\n

According to Dr. Demian, it can be as long as four hours (on average), though. The length of time depends on various factors, he continues, such as other medications consumed, whether the diagnosis is accurate, and the differentiation between different types of headaches.\u00a0<\/span><\/p>\n

Further, how well the body digests and metabolizes the medicine varies from person to person. \u201cSome conditions may lead to inadequate absorption of <\/span>prednisone<\/span>, including kidney and liver impairment and inflammatory bowel disease,\u201d Dr. Hentrich says.<\/span><\/p>\n\t\t

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Prednisone<\/span> dosage for migraines<\/span><\/h2>\n

The general <\/span>prednisone<\/span> dosage<\/span><\/a> for adults is 5 mg to 60 mg per day. A <\/span>high dose<\/span> may be needed for migraines, though.<\/span><\/p>\n

A<\/span>\u00a0study in <\/span>Neurology<\/span><\/i><\/a> gave <\/span>cluster headache<\/span> participants 100 mg of oral <\/span>prednisone<\/span> for five days, then tapered by 20 mg every three days, or a <\/span>placebo<\/span> with an increasing dose of verapamil, starting with 40 mg three times per day. Almost 50% of the participants who took <\/span>prednisone<\/span> experienced a <\/span>headache attack<\/span> reduction, whereas only 14.5% of those who took the <\/span>placebo<\/span> reported the same.<\/span><\/p>\n

Another study by <\/span>Cephalalgia<\/span><\/a> stopped symptomatic medications and started <\/span>prednisone<\/span> in <\/span>tapering<\/span> doses for 6 days, then introduced <\/span>preventive medication<\/span>. It was also successful because 85% of the participants had less frequent headaches during the first six days.\u00a0<\/span><\/p>\n

Pretty promising research, right?<\/span><\/p>\n

Prednisone<\/span> is best taken with food or milk in the morning, and the latter is used to align with the body\u2019s <\/span>corticosteroid<\/span> production. To avoid misuse, follow a <\/span>healthcare<\/span> provider\u2019s instructions on how much to take and how often. <\/span>Prednisone<\/span> dependence<\/span><\/a> is unusual, thankfully, though it can be serious.<\/span><\/p>\n

Comparing <\/span>prednisone<\/span> with other migraine medications<\/span><\/h2>\n

Is one medication for migraines better than another? Dr. Hentrich says no large studies have compared <\/span>prednisone<\/span> to other medications for acute migraine treatment, though a small study has.\u00a0<\/span><\/p>\n

The small study, <\/span>published in <\/span>Headache: The Journal of Head and Face Pain<\/span><\/i><\/a>, compared <\/span>prednisone<\/span> to celecoxib, a prescription <\/span>nonsteroidal anti-inflammatory drug<\/span> (<\/span>NSAID<\/span>) and <\/span>analgesic<\/span>. The results showed that celecoxib was favored during the first three weeks and had fewer <\/span>adverse effects<\/span> than <\/span>prednisone<\/span>.<\/span><\/p>\n

Prescription <\/span>triptans<\/span> and CGRP antagonists are efficacious, too. \u201cHowever, some <\/span>triptans<\/span>, such as intranasal and subcutaneous <\/span>sumatriptan<\/span>, may work more quickly than others,\u201d Dr. Hentrich adds. \u201cCGRP antagonists, such as ubrogepant and rimegepant, are newer agents that are highly effective for acute migraine treatment and have a favorable <\/span>side effect<\/span> profile.\u201d<\/span><\/p>\n

As Dr. Demian mentioned, Botox is considered the gold standard, but only as a <\/span>preventive treatment<\/span>. Otherwise, he doesn\u2019t see a clear winner. \u201c<\/span>Prednisone<\/span> is an effective drug, but as effective as the new generation of <\/span>triptans<\/span>,\u201d he says.<\/span><\/p>\n

The \u201cbest\u201d treatment depends on an individual\u2019s health history.\u00a0<\/span><\/p>\n

According to Dr. Hentrich, jumping straight to prescription medications might not be the answer. He recommends starting with <\/span>NSAIDs<\/span> and combination <\/span>acetaminophen<\/span> products first\u2014and fast. \u201cTaking medications for the acute treatment of migraines at the first sign of a migraine is vitally important for stopping the migraine from progressing,\u201d he says, noting the <\/span>first sign of a migraine is an aura<\/span><\/a>, or visual symptoms, for many people.<\/span><\/p>\n

More natural <\/span>migraine treatments<\/span><\/a>\u2014specifically, ones that can reduce frequency and intensity\u2014include vitamins and <\/span>supplements<\/span>, such as magnesium, riboflavin, feverfew, and butterbur.<\/span><\/p>\n

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The bottom line<\/span><\/h2>\n