Ask Dr. Armstrong: What are some common rescue medications for migraine attacks?

For acute migraine attacks, rescue or abortive medications are designed to stop symptoms that have already begun. They are taken at the onset of a migraine to reduce the severity and duration of the headache. Here’s an overview of some of the common rescue medications for acute migraine:

1. Triptans: These are serotonin receptor agonists that cause blood vessels to constrict and block pain pathways in the brain. Some commonly used triptans include:

    · Sumatriptan (Imitrex, Tosymra)

    · Rizatriptan (Maxalt, Maxalt-MLT)

    · Eletriptan (Relpax)

    · Zolmitriptan (Zomig, Zomig-ZMT)

    · Naratriptan (Amerge)

2. Ergots: An older class of migraine medications.

    · Dihydroergotamine (Migranal, D.H.E. 45)

    · Ergotamine and caffeine combination (Cafergot, Migergot)

3. Lasmiditan (Reyvow): A newer class of medication distinct from triptans, it’s a serotonin 5-HT1F receptor agonist.

4. Ditans: This newer class of drugs targets the 5-HT1F receptor, which is associated with migraine pain. These do not constrict blood vessels like triptans.

5. Gepants: These are calcitonin gene-related peptide (CGRP) receptor antagonists.

    · Ubrogepant (Ubrelvy)

    · Rimegepant (Nurtec ODT)

6. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Some over-the-counter NSAIDs can reduce migraine pain. They include:

  · Ibuprofen (Advil, Motrin IB)

  · Naproxen sodium (Aleve)

  · Aspirin (in combination with caffeine, it might be beneficial for some migraine sufferers)

7. Anti-nausea medications: Often given alongside other medications to address the nausea that can accompany migraines.

8. Opioid medications: These are usually considered only after other treatments fail because they are habit-forming and have dangerous side effects. Opioids are typically reserved for emergency management or as a last resort.

9. Glucocorticoids (Prednisone, Dexamethasone): Sometimes used in conjunction with other medications to enhance their effect or to treat intractable migraines that don’t respond to standard treatments.

It’s essential to use these medications as directed and under the guidance of a healthcare professional. Overuse can lead to rebound headaches, a worsening of symptoms when the medication wears off. Always discuss potential side effects and any other concerns with a physician or pharmacist.