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The Pros and Cons of Migraine Medicines
Medication can help relieve the symptoms of migraines. Find out the pros and cons of commonly used migraine medicines.

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Picture of a woman in pain due to migraine The Pros and Cons of Migraine Medicines

A migraine headache can be disabling, as anyone who's had one knows. In addition to throbbing head pain, migraines can cause other unpleasant symptoms, such as nausea, visual problems, and sensitivity to light and sound. Luckily, medicines can provide relief for most migraine sufferers.

Two types of medicines are available:

  • Acute (or abortive) medicines, which can stop a migraine or reduce the symptoms. They work best if you take them as soon as you feel a migraine coming on.
  • Preventive medicines, which are taken daily to help keep migraines from occurring. Your doctor may prescribe a preventive medicine if you have severe, frequent migraines. It can take a few months for these medicines to become effective.

Here are some general things to keep in mind about migraine medicines:

  • Overuse of acute medicines can lead to rebound headaches. If you take acute medicines too often, even over-the-counter ones, you may get rebound headaches. To avoid this, your doctor may instead prescribe a preventive medicine if you have more than two headaches a week.
  • Preventive medicines can't prevent all migraines. They reduce the frequency and severity of migraines, but you may still have headaches at times.

The following tables show some of the pros and cons of the most common medicines for migraines.

Acute treatment for migraine

Type of medicine



Over-the-counter pain relievers (such as aspirin, naproxen, ibuprofen)

Can buy without a prescription


May cause stomach irritation, liver problems

May cause rebound headaches if overused

Triptans (such as sumatriptan, rizatriptan, zolmitriptan)

Proven effective for most people with migraines

Available as nasal spray and injection as well as pills

Can cause a serious problem if taken with certain antidepressants

Should not be used by people with heart disease or high blood pressure

Ergots (such as ergotamine, DHE)

Available as a nasal spray, which may decrease stomach problems

May be less expensive than triptans

May not work as well as triptans

Compared to triptans, may cause more side effects, including nausea and vomiting

Should not be used by people with heart disease or high blood pressure

Narcotic pain relievers (such as acetaminophen plus codeine)

Strong pain relief

May work when other treatments have failed

Risk of dependence, rebound headaches

May cause dizziness, fatigue, drowsiness

Preventive treatment for migraine

Type of medicine




Safe for people with high blood pressure

Should not be used by people with depression or asthma

Calcium channel blockers

Safe for people with high blood pressure

May cause side effects, such as constipation and slow heart rate


Can treat both migraine and depression

Depending on the medication, side effects may include drowsiness and weight gain

Anti-convulsants (anti-seizure medication)

May be a good choice for people who also have epilepsy or bipolar disorder

Risk of birth defects if taken during pregnancy

By Lila Havens, Staff Writer
Created on 07/17/2008
Updated on 05/09/2011
  • American Headache Society. U.S. Headache Consortium.
  • Green MW. Primary and secondary headaches. In: Rowland LP, Pedley TA, eds. Merritt's Neurology. 12th edition. Philadelphia, PA: Lippincott Williams and Wilkins; 2010.[Ovid via MerckMedicus]
  • American Headache Society. Information for patients: migraine treatments.
  • Snow V, Weiss K, Wall EM, Mottur-Pilson C. Pharmacologic management of acute attacks of migraine and prevention of migraine headache. Annals of Internal Medicine. 2002;137:840-849.
  • DeMaagd G. The pharmacological management of migraine, part 1:overview and abortive therapy. Pharmacy and Therapeutics. 2008;33(7):404¿416.
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