Abortive medications used to stop the acute migraine early in the onset are used on an as-needed basis. The major class of medications used for this is the triptans that bind to the serotonin receptors along the trigeminal nerve and help to turn off the release of the inflammatory chemicals discussed above before the process gets established. This class includes the brand names of Imitrex, Treximet, Sumavel, Maxalt, Relpax, Axert, and Zomig. NSAIDs such as naproxen or diclofenac may be used in combination to treat the attack. Very often a person will not have a good response to one triptan or have side effect but have a miraculous benefit to another to get the person back into life.
Note that the overuse of medications to include acetaminophen, aspirin, ibuprofen, triptans, butalbital, caffeine (and more) can cause a new type of headache, called Medication Overuse Headache or MOH. MOH, as noted above, can transform the migraine disorder into a daily headache syndrome that will not respond to any treatment option until the medication that is perpetuating the headache cycle is stopped. We have methods of breaking that cycle and getting off these medications without excessive stress on the system or rebound headaches.
The triptan or DHE medications are used to stop the migraine pain by treating the cause of the pain. The use of direct pain relieving medications such as opiods can occasionally be utilized for rescue treatment but in only very limited amounts. The objective of our clinic is to develop the treatment program to control the disorder rather than covering it over with pain medications. Pain medications will be not be refilled through this office since that is not our role.