Taking Control of Your Migraine: Is It Time for a Change?

This article is for people with migraine and their care partners, or anyone who wants to learn more about migraine treatment. The goal of this activity is to help people with migraine engage in shared decision-making with their doctors about their migraine treatment and if a different treatment may be recommended.

You will learn about:

• Medicines used as acute and preventive migraine treatment

• Potential side effects of migraine medicines

• Reasons why your migraine treatment may not be working

• Ways to help manage migraine attacks

• Questions to ask your doctor

Whether you haven't started migraine treatment yet, paused treatment, or are currently taking treatment, you and your doctor will work together to find a treatment plan that best fits your needs. This may include medicines and other treatments, such as medical devices, behavioral treatment, and lifestyle changes.

The goals of your treatment plan will to be to relieve your pain and other symptoms, decrease the length and severity of your migraine attacks, prevent any future attacks, and help you have the best quality of life you can.

Acute migraine treatment is taken to stop or relieve symptoms during an attack. It works best when taken at the first sign of an oncoming attack.

Acute medicines can include:

• Serotonin agonists, such as "triptans" or "ditans"

• Ergotamines

• Calcitonin gene-related peptide (CGRP) antagonists, such as "gepants"

Your doctor may also recommend other medicines to help with your symptoms.

Preventive migraine treatment is taken regularly or daily to help keep migraine attacks from happening. It works to decrease how often you get migraine attacks, how severe they are, and how long they last.

Preventive medicines can include:

• Beta-blockers

• Serotonin antagonists

• Anti-seizure medicines

• Neuromuscular blockers

• CGRP antagonists, such as certain monoclonal antibodies

If you have known triggers that can bring on your migraine attacks, your doctor will recommend avoiding them and may also recommend certain lifestyle changes to help prevent attacks.

Some common side effects that may happen with migraine medicines can include:

• Nausea, vomiting, diarrhea, constipation, weight changes

• Dizziness, weakness

• Sleepiness, fatigue (tiredness)

• Trouble sleeping

• Hair loss

• Vision problems

• Neck pain

• Tightness or pressure in your jaw, throat, or chest

• Burning, numbness, or tingling in your hands, feet, arms, or legs

• A temporary reaction at the spot where a medicine was injected

Not all side effects are listed here. Ask your doctor for a full list, which side effects can happen with your treatments, and when you should contact them or go to the emergency room because of side effects.

Sometimes migraine treatment can stop working, or not relieve your symptoms as well as you'd like it to. Other times, certain medicines may have side effects that can't be tolerated or managed. All of these may interfere with your daily activities and can impact your quality of life.

If this happens, it may be time to rethink your treatment and talk to your doctor -- sometimes trying a different treatment can help.

Just remember, it's important that you don't stop or change your migraine treatment without talking to your doctor first.  

Your acute migraine medicine may not be working as well as it can for you if you're:

• Not getting the same relief with the same amount of medicine

• Having more than 4 migraine attacks a month

• Taking your medicine more than 10 days a month

Your migraine medicine may have stopped working for you, or isn't working as well as it should or used to, if you:

1. Wait too long to take your acute medicine

2. Take your acute medicine too often

3. Don't take your preventive medicine as directed  

4. Have new or unknown triggers

Sometimes changing migraine treatment can help. Your doctor may recommend a different treatment or medicine if your:

• Attacks are getting worse or happening more often

• Symptoms have changed because of new or different triggers, hormone or health changes, or as you get older

• Side effects can't be tolerated or managed or are too severe

• Reason for migraine attacks is new or different 

• Other health conditions, such as heart problems, affect which medicines you can take

But if your migraine treatment is working for you, your doctor may recommend you keep taking it. So be sure to check with them before changing or stopping your treatment.

In addition to treatment, there are lifestyle changes and other ways you can help manage migraine attacks and have the best quality of life possible, such as:

• Be on the lookout for triggers and avoid them whenever possible

• Make sure you're taking your treatment as directed

• Track your attacks, symptoms, triggers, any side effects, and how you're taking your medicines in a journal or diary

• Quit smoking

• Eat a balanced diet and limit alcohol

• Maintain a healthy weight and stay active

• Get enough sleep

• Develop coping strategies to reduce stress

• Tell your doctor about all medicines you take -- even those you can get without a prescription -- and herbals and supplements

Questions you can ask your doctor about managing migraine can include:

• What treatments are available, and what are their side effects?

• How will I know if treatment's working?

• Are there any lifestyle changes I should make?

• How can I have the best quality of life possible?

• What should I do if I start to feel stressed or depressed?

• Where can I find additional resources and information?

Congratulations!

You have successfully completed the program Taking Control of Your Migraine: Is It Time for a Change?

View Additional Materials on this topic that you may find useful:

Migraine Information Page

Migraine -- Office on Women’s Health

What Is Chronic Migraine?

AMF Patient Guides