What Are the Best Migraine Treatments and Remedies?

A migraine is a painful type of headache that can happen again and again. Some people experience visual or sensory changes (called a migraine aura), before their pain begins. Migraines can also cause other symptoms like an upset stomach, fatigue, and sensitivity to light 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 that can help your migraine attacks.

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 nonsteroidal anti-inflammatory drugs (NSAIDs or acetaminophen (Tylenol), and prescription medications like 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.

OTC migraine treatments

As many as 40% of people who experience migraines never get medical treatment. Instead, they try to manage their headaches on their own. The two mainstays of OTC migraine treatment are NSAIDs and acetaminophen. 

1. 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 often work better than acetaminophen (Tylenol).

Some NSAIDS used for migraines include:

• Aspirin (Bayer, Ecotrin)

• Ibuprofen (Advil, Motrin)

• Naproxen (Aleve, Naprosyn)

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There’s some evidence that certain NSAIDs may help prevent migraines before they start. But using them too often can lead to medication overuse headaches (also known as rebound headaches). The risk of rebound headaches is higher with NSAIDs than with triptans.

2. Acetaminophen (Tylenol)

Acetaminophen (Tylenol) is another common OTC pain medication. It may help relieve migraine pain by blocking pain signals in your brain. But unlike NSAIDs, it doesn’t help reduce inflammation.

Acetaminophen options for migraine headaches include:

• Acetaminophen (Tylenol)

• Acetaminophen / caffeine / aspirin (Excedrin Migraine)

Headache specialists generally don’t recommend combination medications (like Excedrin Migraine). These are more likely to cause rebound headaches. This may be because acetaminophen is less effective than NSAIDs in treating migraines, so people are more likely to take it too often. Also, the caffeine in some combination medications may trigger migraines for some people.

Comparing OTC migraine treatments

While both NSAIDs and acetaminophen treat migraines, each has its pros and cons. Here is a comparison below.

Prescription migraine treatments

When OTC medications aren’t effective for treating migraines, prescription medications may be able to help. A recent meta-analysis looked at 137 studies on medications to treat migraines. The authors concluded that triptans are the most effective for stopping migraine pain within 2 hours of it starting. Guidelines now recommend adding triptans to OTC treatments for moderate to severe migraine headache pain. 

But each person is different. A healthcare professional will help you choose the best treatment based on your medical history and symptoms. Let’s take a look at some of the different types of prescription migraine treatments.

1. 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.

Triptans for migraines include:

• Naratriptan (Amerge)

• Zolmitriptan (Zomig)

• Rizatriptan (Maxalt)

• Almotriptan 

• Frovatriptan (Frova)

• Eletriptan (Relpax)

• Sumatriptan (Imitrex)

• Sumatriptan / Naproxen (Treximet)

Triptans work well to lessen nausea associated with migraines. Since they can be taken in many forms (such as pills, injections, or nasal spray), they're especially good for people who have nausea and vomiting with their migraines. 

Triptans are generally most effective when taken at the start of a headache. Some people may have uncomfortable side effects with these medications, such as jaw tightness or fatigue.

2. CGRP receptor inhibitors

If NSAIDS or triptans don’t help, calcitonin gene-related peptide (CGRP) antagonists may be an option. These work on receptors in your brain to lessen inflammation and headache pain. 

CGRP receptor inhibitors include medications like:

• Ubrogepant (Ubrelvy)

• Rimegepant (Nurtec)

• Galcanezumab-gnlm (Emgality)

• Atogepant (Qulipta)

• Fremanezumab (Ajovy)

• Zavegepant (Zavzpret)

• Erenumab (Aimovig)

• Eptinezumab (Vyepti) 

Ubrogepant and rimegepant don’t seem to cause vasoconstriction (blood vessel narrowing). This might make them safer for people with cardiovascular disease.

3. Reyvow

Reyvow (lasmiditan) is a serotonin agonist. It only works on specific serotonin receptors in your brain. It’s taken by mouth when you’re having a migraine. Many people feel relief within 2 hours. Side effects include dizziness, sleepiness, and a "pins-and-needles" feeling. 

Because lasmiditan works on receptors in your brain, it doesn’t affect blood vessels in your body or heart. So, it may be safer than triptans for people with cardiovascular disease.

Reyvow is listed as a controlled substance because of the risk of abuse. There’s no generic version available yet. 

4. 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 blood vessels in your brain to lessen migraine pain. Because of this, it’s not safe for people with a history of heart or blood vessel disease. Dihydroergotamine examples include: Dihydroergotamine (D.H.E. 45) and migranal nasal spray.

This medication isn’t well absorbed when taken as a pill or tablet. It must be given as an injection, nasal spray, or intravenous (IV) infusion.

5. 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.

Examples of anti-nausea medications for migraines include:

• Ondansetron (Zofran)

• Chlorpromazine 

• Metoclopramide (Reglan)

• Prochlorperazine

• Promethazine (Phenergan)

Anti-nausea medication can make your other migraine medications work better. That’s because having an upset stomach can make it harder for your body to absorb medication.

Comparing prescription migraine treatments

The chart below compares the pros and cons of different types of prescription migraine medications.

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. 

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

In addition to medications, natural, complementary, and alternative 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)

• Getting enough 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. While food doesn’t seem to help a migraine attack that’s already in progress, eating a nutritious diet can help migraines overall.

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

Some herbs and supplements may also help prevent migraines. For example, ginger powder may be especially helpful during an acute attack. 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 people, 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 a practitioner's office.

Medical therapies for migraines

Various medical therapies can help manage acute migraines. Specialized neurostimulation devices may be able to change how your body feels and processes pain. There are a wide variety of neurostimulation devices that can be used to treat chronic headaches. They can provide pain relief without using medications and are generally safe and well tolerated.

Neurostimulation devices can be used in a doctor’s 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 their skin. This device connects to your nerves and helps relieve pain. 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 symptom patterns, aura, and headache patterns. 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

• Avoiding triggers

• 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, find your 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 medications 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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