How to Get Rid of a Migraine

Migraines are intense headaches often accompanied by nausea, sensitivity to light or sound, and visual disturbances. They can last from a few hours to several days and significantly impact daily life. The good news is that there are evidence-based strategies—both non-drug and drug-based—that can help you find relief sooner.

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1. Understand Your Migraine

Migraines aren’t just bad headaches. Key features include:

• Throbbing or pulsing pain, usually on one side of the head
• Moderate to severe intensity, worsened by routine activity
• Nausea or vomiting
• Sensitivity to light (photophobia) and sound (phonophobia)
• Aura in some people: visual or sensory changes that precede pain

Knowing your personal warning signs (aura, mild pre-pain discomfort, mood changes) helps you start treatment early, which improves success.

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2. Immediate, Non-Drug Relief

At the first hint of migraine pain or aura:

1. Find a quiet, dark room
   • Lie down. Turn off lights and close blinds.
   • Use earplugs or noise-cancelling headphones.

2. Apply a cold compress
   • Place an ice pack or wrapped frozen peas on your forehead or neck for 10–20 minutes.
   • Repeat as needed, with 10-minute breaks between applications.

3. Hydrate
   • Dehydration can worsen pain.
   • Sip water or an electrolyte drink.

4. Caffeine in small doses
   • 50–100 mg (about half a cup of coffee) may enhance pain relief if taken early.
   • Avoid excessive caffeine—it can trigger rebound headaches.

5. Practice gentle relaxation
   • Deep breathing: Inhale for 4 counts, exhale for 6 counts, repeat 5–10 times.
   • Progressive muscle relaxation: Tense and relax major muscle groups from toes to head.

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3. Over-the-Counter (OTC) Medications

When non-drug measures aren’t enough, OTC options can help:

• NSAIDs (ibuprofen, naproxen)
  • Reduce inflammation and pain.
  • Naproxen 500 mg often helps if taken at pain onset.
• Acetaminophen (paracetamol)
  • Less stomach irritation than NSAIDs.
  • Can be combined with other agents.
• Combination analgesics (e.g., acetaminophen + aspirin + caffeine)
  • Effective for many, but watch out for medication-overuse headache if used >10 days/month.

Always read labels and follow dosing instructions. If you need OTC meds more than a few times per week, talk to your doctor about prescription options.

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4. Prescription Medications for Acute Migraine

Triptans

Triptans are migraine-specific drugs that work by narrowing blood vessels and blocking pain pathways in the brain.

• Sumatriptan
  • Available as tablets, nasal spray, or injection.
  • Onset: 30–60 minutes for tablets; faster for injection or nasal spray.
• Other triptans: rizatriptan, eletriptan, zolmitriptan.

Evidence
The American Headache Society’s 2019 review (Silberstein & Cady) supports triptans as first-line therapy when OTC meds fail.

Combination Therapy: Sumatriptan + Naproxen

• A landmark Lancet study (Derry & Moore, 2013) showed that taking sumatriptan (85 mg) plus naproxen sodium (500 mg) at migraine onset:
  • Achieves faster, more sustained pain relief than either drug alone.
  • Reduces the chance of headache returning within 24 hours.

Ditans and Gepants

• Lasmiditan (a ditan) and ubrogepant/ rimegepant (gepants) are newer options, especially if triptans are not suitable (e.g., cardiovascular issues).

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5. Non-Drug, Non-Prescription Therapies

Behavioral Techniques

• Biofeedback: Teaches control over muscle tension and blood flow.
• Cognitive-Behavioral Therapy (CBT): Helps manage stress and migraine triggers.

Supplements and Nutraceuticals

• Magnesium: 400–600 mg daily may reduce frequency.
• Riboflavin (Vitamin B2): 400 mg daily shown to decrease attacks.
• Coenzyme Q10: 100 mg three times daily may help some people.

Always check with your doctor before starting supplements, especially if you’re on other medications.

Acupuncture and Physical Therapy

• Some people find benefit from acupuncture sessions.
• Stretching and strengthening neck and shoulder muscles may reduce tension that can trigger migraine.

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6. Lifestyle and Trigger Management

Preventing migraines often means identifying and avoiding personal triggers. Keep a headache diary to track:

• Sleep patterns (aim for consistent hours)
• Meal times and blood sugar levels (avoid long gaps without food)
• Hormonal changes (menstrual cycles in women)
• Stress levels and coping strategies
• Environmental factors (bright lights, strong smells, loud noises)
• Weather changes and altitude shifts

Healthy habits make a difference:

• Get 7–9 hours of sleep nightly on a regular schedule.
• Eat balanced meals at regular intervals.
• Exercise moderately most days (walking, swimming, cycling).
• Practice stress-reduction daily (meditation, yoga, deep breathing).

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7. When to Seek Medical Care

While most migraines respond to these strategies, certain signs require prompt medical attention:

• Sudden, severe headache (“worst headache of my life”)
• Headache with fever, stiff neck, confusion, weakness or vision loss
• New headache after age 50
• Headache following head injury
• Progressive worsening over days or weeks

If you ever worry your migraine could be something more serious, don’t hesitate to symptom check for free online or contact emergency services.

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8. Preventive (Prophylactic) Treatment

If you have more than 4 migraine days per month, preventive medication may be recommended:

• Beta-blockers (propranolol, metoprolol)
• Antidepressants (amitriptyline, venlafaxine)
• Anti-seizure drugs (topiramate, valproate)
• CGRP monoclonal antibodies (erenumab, fremanezumab)

Preventive treatments take weeks to months to gauge effectiveness. Work closely with your doctor to adjust doses and manage side effects.

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9. Key Takeaways

• Start non-drug measures (dark room, cold compress, hydration) at the first sign of migraine.
• Use OTC NSAIDs or acetaminophen early; watch for overuse.
• If OTC meds fail, triptans are first-line; sumatriptan + naproxen offers superior relief.
• Explore non-drug therapies: relaxation, biofeedback, supplements.
• Track triggers with a diary; maintain regular sleep, meals, and exercise.
• Seek immediate care for red-flag symptoms.
• Speak with your doctor about preventive options if migraines occur frequently.

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Speak to a doctor if you ever experience alarming symptoms or if your migraines interfere with daily life. A healthcare professional can tailor treatments to your specific needs and ensure nothing serious is overlooked.