Migraine
Repeated attacks of throbbing headache, often with nausea and sensitivity to light and sound. Some people get an aura (flashing lights or zigzags) first.
Treatment options
Ratings show how strong the research is.
- Strong evidencePain relief, taken earlyAspirin, ibuprofen or paracetamol at the first sign of headache. Follow the packet directions.
- Strong evidenceAnti-nausea medicineTaken with pain relief, it helps with nausea and helps the pain relief work.
- Strong evidenceTriptansMigraine-specific tablets or sprays, on prescription. Use if pain relief alone isn’t enough.
- Strong evidencePreventive tabletsIf attacks are frequent (4 or more days a month) or disabling. Several options, such as propranolol, amitriptyline or candesartan.
- Strong evidenceSpecialist injectionsFor frequent migraine when tablets haven’t worked, via a neurologist.
- Moderate evidenceMagnesium or riboflavinMay reduce attacks. Try one for 3 months. Check with your pharmacist first.
- Moderate evidenceRelaxation and CBTHelp reduce how often attacks happen.
- Not recommendedPain relief most daysSimple pain relief on 15 or more days a month, or triptans on 10 or more, can cause rebound (medication-overuse) headaches.
What you can do
- Regular sleep and meal times. Drink enough water.
- Limit caffeine to 1 to 2 cups a day.
- Keep a headache diary to spot triggers.
See your GP if
- Attacks are frequent or getting worse
- You use pain relief more than 2 to 3 days a week
- Headaches have changed pattern
Call 000 or go to the emergency department for a sudden severe "worst ever" headache, fever with a stiff neck, new weakness, confusion or trouble speaking.
Evidence and more information
maladywise.com/migraine/