Treatments that work depend on how severe your migraine is and what triggered it

Migraine relief falls into two categories: stopping an attack once it starts, and preventing attacks from happening in the first place. What works varies widely between people—a medication that stops one person's migraine in 20 minutes may do nothing for another. The goal is finding what interrupts your specific pattern, which usually takes trial and adjustment with a doctor.

Most people start with over-the-counter pain relievers during an attack, then move to prescription medications if those don't work. Prevention is separate: it involves taking medication or making lifestyle changes regularly, whether or not you have a migraine that day. Many people use both approaches at once.

Key Takeaways

  • Over-the-counter pain relievers like ibuprofen or naproxen work best if taken early in a migraine, before pain becomes severe.
  • Prescription medications called triptans are designed specifically for migraine and work by narrowing blood vessels and blocking pain signals in the brain.
  • Prevention medications—taken daily regardless of whether you have a migraine—reduce how often attacks happen and how bad they are.
  • Non-medication approaches like ice, rest in a dark room, and identifying your triggers can reduce migraine frequency and severity.
  • What works differs between people, so finding your treatment usually means trying options with your doctor and tracking what actually stops your attacks.

Over-the-counter pain relievers during an attack

Ibuprofen (Advil, Motrin) and naproxen (Aleve) are nonsteroidal anti-inflammatory drugs, or NSAIDs. They reduce inflammation and block pain signals. For migraine, they work best if you take them as soon as you feel an attack starting—before pain becomes severe. A typical dose is 400 to 600 mg of ibuprofen or 220 to 500 mg of naproxen, though your doctor may recommend different amounts.

Acetaminophen (Tylenol) is less effective for migraine than NSAIDs, but some people find it helps, especially combined with caffeine. The combination of acetaminophen, aspirin, and caffeine is sold as Excedrin Migraine and is designed for this purpose.

The main limitation of over-the-counter options is that they often don't work for moderate to severe migraines. If you find yourself taking them more than two days a week, talk to your doctor—frequent use can actually cause more migraines over time, a pattern called medication overuse headache.

Prescription medications that target migraine specifically

Triptans are the most common prescription migraine treatment. They work by narrowing blood vessels around the brain and blocking pain pathways. Common triptans include sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig). They come as pills, nasal sprays, or injections. Most people take them as soon as a migraine starts, and they typically reduce pain within 30 to 60 minutes if they work for you.

Triptans don't work for everyone—roughly 30 to 40 percent of people don't respond to them—and different triptans work differently in different people. Your doctor may have you try more than one to find which helps. Triptans can cause side effects like dizziness, chest tightness, or tingling, and they're not safe for people with certain heart conditions.

CGRP inhibitors are newer medications (erenumab, fremanezumab, eptinezumab) that block a protein involved in migraine. They're given as injections or infusions and are used for prevention rather than stopping an active migraine. They reduce migraine frequency in some people by 30 to 50 percent.

Lasmiditan (Reyvow) is a newer option that works differently from triptans and may help people who don't respond to them or can't take them safely.

Daily prevention medications

If you have migraines more than four times a month, or if your migraines are severe enough to disrupt your life, prevention medication may help. These are taken every day, whether or not you have a migraine.

Beta-blockers like propranolol (Inderal) and metoprolol reduce how often migraines happen and how intense they are. They're often a first choice because they're inexpensive and have been used for decades. Calcium channel blockers like verapamil work similarly.

Antidepressants like amitriptyline reduce migraine frequency, even in people without depression. Anticonvulsants like topiramate (Topamax) and valproic acid also prevent migraines, though they carry more side effects than some other options.

Prevention medications typically take four to eight weeks to show results, and you may need to adjust the dose. Finding the right one often means trying more than one option.

Non-medication approaches that reduce migraine frequency

Identifying and avoiding triggers is the foundation of migraine management. Common triggers include certain foods (aged cheese, processed meats, alcohol, caffeine withdrawal), hormonal changes, sleep disruption, stress, and weather changes. Keeping a migraine diary—noting when attacks happen and what happened before—helps you spot your patterns. Once you know your triggers, avoiding them can reduce how often you get migraines.

Sleep, hydration, and regular meals matter more than they sound. Skipping meals, dehydration, and irregular sleep are common migraine triggers. Maintaining a consistent sleep schedule and eating at regular times can reduce frequency.

Stress management through exercise, meditation, or other relaxation techniques reduces migraine frequency in some people. Regular aerobic exercise appears particularly helpful.

During an active migraine, resting in a dark, quiet room, applying ice to your head or neck, or taking a warm shower can ease pain while you wait for medication to work. Some people find pressure on the temples helpful.

What to do if your current treatment isn't working

If over-the-counter pain relievers don't stop your migraines, see your doctor before assuming you need prescription medication. They'll ask about your migraine pattern, what you've tried, and whether anything makes it better or worse. This information helps them choose a medication more likely to work for you.

If a prescription medication doesn't work after a fair trial—usually at least two to three uses—tell your doctor rather than giving up on treatment. Different medications work for different people, and trying another option is standard practice. Some people need to try three or four before finding one that helps.

If you're having migraines more than 15 days a month, or if they're getting worse, mention this to your doctor. That pattern can indicate medication overuse headache or a change in your migraine that needs different treatment.

Frequently Asked Questions

Can I take migraine medication every day to prevent attacks?

Yes—that's exactly what prevention medications do. They're taken daily whether or not you have a migraine, and they reduce how often attacks happen. This is different from taking pain relief medication during an attack. Taking pain relief medication every day can actually cause more migraines over time.

Why doesn't the same medication work for everyone?

Migraine involves multiple biological pathways—blood vessel changes, inflammation, nerve signaling—and different people's migraines involve different pathways. A medication that blocks one pathway helps some people but not others. This is why your doctor may have you try more than one option.

How long does it take for prevention medication to work?

Most prevention medications take four to eight weeks to show results. You need to take them consistently during this time even if you don't notice improvement right away. If there's no change after eight weeks, your doctor may adjust the dose or try a different medication.

Is it safe to use migraine medication while pregnant?

Some migraine medications are safer in pregnancy than others. Triptans are generally considered safe, but some prevention medications are not. If you're pregnant or planning to become pregnant, talk to your doctor about which options are safe for you—don't stop treatment without guidance.

What's the difference between a migraine and a regular headache?

Migraines typically involve throbbing pain on one side of the head, often with nausea, sensitivity to light, or sensitivity to sound. Regular tension headaches are usually steady pressure on both sides. Migraines last four to 72 hours; tension headaches are usually shorter. The medications that work for migraine don't work well for tension headaches.