What Are the Best Migraine Treatments and Remedies?

A migraine is a type of recurring, painful headache. Some people experience visual or sensory changes, known as a migraine aura, before their pain begins. Migraines can also cause other symptoms like an upset stomach, fatigue, and sensitivity to light and/or sound.

Migraines can last for several hours or even days. And symptoms can be severe enough that they disrupt daily activities. Fortunately, there are many options to help treat migraines. Let’s take a closer look at the best medications, home remedies, and other treatments to help your migraine attacks.

Choosing the right migraine treatment and medication

Depending on your situation, you and a healthcare professional can decide together which treatments are best for you. These might include medications to treat migraines when they occur (acute treatments). Treatments might also be medications that you take on a daily basis to prevent migraines from starting in the first place (preventive). Some medications can do both jobs. Here, we’ll focus on acute treatments.

Migraine medications come in many different forms:

• Oral pills

• Dissolvable tablets

• Nasal sprays

• Injections

• IV (intravenous) infusions

What are the best acute treatments for migraines?

There are many types of medications that can stop an acute migraine attack in progress. First-choice medications often include over-the-counter (OTC) pain relievers like NSAIDs or acetaminophen (Tylenol), triptans, and anti-nausea medications. These can be used alone or in combination with each other. Let’s take a closer look at these medications.

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OTC migraine treatments

As many as 40% of people who experience migraines never seek medical treatment, instead managing the headaches on their own. The two mainstays of OTC migraine treatment are NSAIDs and acetaminophen. 

NSAIDs

NSAIDs are a well-known remedy for managing migraines. They work by directly relieving headache pain and inflammation. Many NSAIDs are inexpensive, easy to get without a prescription, and well tolerated. All NSAIDs seem to be equally helpful for migraines and they work better than acetaminophen (Tylenol).

Acetaminophen (Tylenol)

Acetaminophen (Tylenol) is a common OTC pain medication. It may help block pain signals in your brain, which relieves migraine pain. Unlike NSAIDs, acetaminophen doesn’t help lessen inflammation.

Prescription migraine treatments

When OTC medications aren’t effective for treating migraines, prescription medications may be able to help. A recent meta-analysis published in BMJ looked at 137 studies on medications to treat migraines. The authors concluded that triptans are the most effective for relieving migraine acutely within 2 hours of onset. 

But each person is different, and you have to choose the best treatment given your medical history and symptoms. One class of medication may not work for you, but fortunately there are other options. Let’s take a look at the different types of prescription migraine treatments.

Triptans

Triptans are used to stop a migraine in progress. If NSAIDs aren’t helpful, a healthcare professional may recommend trying a triptan. These medications help to lessen inflammation and pain during a migraine. They can also help with symptoms like nausea and light sensitivity.

Other migraine-specific medications

For people who don’t respond to NSAIDS or triptans, medications developed for acute migraines may be an option. These medications work on receptors in the brain to lessen inflammation and headache pain.

Dihydroergotamine

Dihydroergotamine is an older medication. It’s generally used when other medications haven’t been successful or for migraines lasting more than 3 to 4 days. Dihydroergotamine narrows the blood vessels in your brain to lessen migraine pain. So, it’s not safe for people with a history of heart or blood vessel disease.

Antiemetics (anti-nausea medication)

If you have nausea and vomiting with your migraines, a healthcare professional may also suggest a medication to help with these symptoms. These block signals in your brain that cause nausea and vomiting. 

Anti-nausea medication is often combined with NSAIDs and triptans. They generally work best if taken before nausea and vomiting are severe.

What are the best natural and complementary migraine remedies to try at home?

In addition to medications, natural, complementary, and alternative medicine treatments may help reduce migraine pain. These include home remedies like:

• Applying hot or cold packs to your neck, head, or belly

• Acupressure (pushing on specific pressure points on your body)

• Self-massage or compression (squeezing your head or temples)

• Aromatherapy (like lavender or mint)

• Sleep 

Food, drink, and supplements for migraine treatment

Foods and drinks are important to consider during a migraine attack. Staying hydrated with water or electrolyte-replacement drinks may help improve your symptoms. This is especially important if you have been vomiting. Although food doesn’t seem to help a migraine attack that’s already in progress, a healthy diet can help migraines overall.

Caffeine can help lessen headache pain, especially if used at the start of a headache. But too much caffeine may cause withdrawal headaches, especially if used on a daily basis. If caffeine is helpful for your migraines, talk with a healthcare professional about how to use it safely.

There are many herbs and supplements that may help prevent migraines. For an acute attack, ginger powder may be especially helpful. In one study, ginger worked as well as sumatriptan for relieving migraines. Ginger is also a cheap and effective treatment for nausea and vomiting.

Avoiding migraine triggers

Learning about and avoiding your migraine triggers can help you prevent and manage attacks. Common migraine triggers include:

• Stress

• Lack of sleep

• Certain foods like alcohol, processed meats, and aged cheese

• Strong odors, bright lights, or loud noises

• Extreme physical activity

Keeping a headache diary can help you figure out your triggers and learn to avoid them.

Therapy and acupuncture

Working with other healthcare professionals like therapists or acupuncturists can provide additional support for managing migraines. 

Cognitive behavioral therapy (CBT) can help you learn to manage your migraine attacks. CBT can help with stress and mood, while teaching you pain-management techniques like:

• Biofeedback

• Meditation

• Progressive muscle relaxation

• Visualization

For some, these skills can reduce or stop migraine pain and other symptoms during an attack.

There’s also evidence that acupuncture can prevent migraines. It can also help with an attack in progress. For acute relief during a migraine attack, acupuncture is generally done in-office.

Medical therapies for migraines

Various medical therapies can help manage acute migraines. Specialized neurostimulation devices may be able to change how your body perceives and processes pain. There are a wide variety of neurostimulation devices that can be used to treat chronic headaches. These devices can help some people get pain relief without the use of medications. They are generally safe and well-tolerated.

Neurostimulation devices can be used in-office or prescribed for home use. These devices deliver a painless electrical current through your skin to help reduce pain. 

When all other treatments haven’t worked, some people may choose to try a type of neurostimulation device that’s embedded under the skin. This device connects to your nerves and offers pain relief. People generally work with a pain specialist to use and manage this device.

What to do if you keep having migraines

Having a plan to manage your migraines at home is important. Keeping a migraine diary can help you understand your own unique prodrome, aura, and headache symptoms. By working with a healthcare professional, you can create a plan for managing your migraine headaches. 

A good migraine management plan includes:

• Medication

• Home remedies

• Trigger avoidance

• Complementary therapies (like acupuncture or CBT)

Using a headache tracking tool (like an app or printable diary) is a great strategy to help you understand your migraines, identify triggers, and learn which treatments work the best.

Tracking your headaches and medications can also help you avoid medication overuse headaches. 

You may be having rebound headaches if your migraines are getting worse or if your medications don’t seem to be working very well. A healthcare professional can help you manage these issues by setting limits on certain medication use and developing a more effective treatment strategy.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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