Acute Migraine Treatment: A Guide to Medication Options When choosing a migraine treatment for acute attack relief, the American Headache Society suggests following these steps. To support primary care clinicians in diagnosis and management of migraine headache, the American Headache Society (AHS) has developed a turn-key virtual CME-accredited program that addresses topics from migraine epidemiology to patient selection for newly approved acute and preventive medications. The following short overview is based on the AHS module on selecting an acute treatment, from First Contact: Headache in Primary Care. 1. Migraine assessment - history or present illness. Ask patient about migraine fequency and what types of self treatment have and haven't worked. 2. Before selecting migraine medication, explore with the patient any comorbidities or medications that may contraindicate acute migraine Tx. 3. Review available acute migraine medications - to include NSAIDs, triptans, gepants, ditans, and antinausea medications.
Note: *Metoclopramide, prochlorperazine and promethazine have addiIonal direct anI-migraine effect but may be sedaIng, and ondansetron has no direct anI-migraine effect but is not sedaIng.
4. Make a migraine treatment action plan. Based on number of monthly headaches and severity, choose to start a migraine-specific agent or stratify care. 5. Clarify medication limits with the patient. Explain that medication limits are in place for the patient's safety and to prevent overuse of acute treatments. Currently available acute migraine medications - treatment frequency and limits. Acute migraine medications - most common side effects by class and other treatment considerations. Previous Next