Education

Treatment Options

A plain-language overview of the medications, devices, behavioral approaches, and procedures used to treat migraine today.

There is no single “best” treatment for migraine — what works depends on your specific type, frequency, severity, medical history, and personal preferences.

Most patients benefit from a combination approach — preventive medication plus acute medication plus lifestyle modifications. When that combination is not enough, procedures like TEMMA may be appropriate.

Acute (abortive) medications

Taken at the onset of a migraine attack to stop or reduce its severity. Used no more than 2 days per week to avoid medication-overuse headache.

Triptans

Sumatriptan, rizatriptan, and others. Target serotonin receptors and reduce dural inflammation.

NSAIDs

Ibuprofen, naproxen, diclofenac. Anti-inflammatory pain relief.

DHE (dihydroergotamine)

An older medication that constricts blood vessels and reduces migraine pain.

Gepants

Newer class (ubrogepant, rimegepant) that block CGRP. Used when triptans are not appropriate.

Preventive medications

Taken daily (or monthly, for some injectables) to reduce migraine frequency and severity over time.

CGRP monoclonal antibodies

Erenumab, fremanezumab, galcanezumab, eptinezumab. Monthly or quarterly injections. Modern, well-tolerated.

Beta blockers

Propranolol, metoprolol. Originally developed for blood pressure, but effective for migraine prevention.

Antidepressants

Amitriptyline, venlafaxine. Used at low doses for migraine prevention.

Anticonvulsants

Topiramate, valproate. Effective for some patients but with more side effects.

OnabotulinumtoxinA (Botox)

FDA-approved for chronic migraine. Injections every 12 weeks.

Devices

Non-drug options that use electrical or magnetic stimulation to interrupt migraine activity.

Cefaly

External trigeminal nerve stimulator. Worn on the forehead for 20 minutes daily.

SpringTMS / eNeura

Single-pulse transcranial magnetic stimulation. Held to the back of the head.

Nerivio

Wearable remote electrical neuromodulation device. Controlled by smartphone.

Behavioral and lifestyle

Often underused but important components of a comprehensive migraine plan.

Trigger identification

Common triggers include sleep changes, certain foods, stress, hormonal changes, weather shifts, and sensory stimuli.

Sleep hygiene

Consistent sleep–wake times are one of the most powerful migraine modulators.

Regular exercise

Moderate aerobic exercise has been shown to reduce migraine frequency in many patients.

Stress management

Cognitive behavioral therapy, biofeedback, and mindfulness have strong evidence in migraine.

Dietary review

Identifying food triggers (often under-emphasized). Hydration, regular meals, and limiting alcohol are common starting points.

Procedures (including TEMMA)

For patients who have not found adequate relief with other options, several procedures are available.

TEMMA (Targeted Embolization for Migraine Management)New

A new application of MMA embolization for severe migraine. Same-day procedure, drug-free, intended to be long-lasting.

OnabotulinumtoxinA (Botox) injections

FDA-approved for chronic migraine. Injections every 12 weeks across 31 head and neck sites.

Occipital and trigeminal nerve blocks

Local anesthetic injections near specific nerves. Used for both treatment and prevention.

Sphenopalatine ganglion stimulation

An implanted device that stimulates a facial nerve cluster involved in migraine. Used in highly refractory cases.

Not sure where to start?

A consultation with a migraine specialist is the fastest way to find the right combination for you.

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