Common misunderstandings about migraine medications.
Migraine medications are often misunderstood, leading to misconceptions about their use, effectiveness, and side effects. Here are some of the most common misunderstandings about migraine medications, along with the facts to clarify them:
1. Myth: Over-the-counter pain relievers work for everyone.
Fact: While over-the-counter (OTC) medications like ibuprofen, aspirin, and acetaminophen can help some people with mild migraines, they are often insufficient for those with moderate to severe migraines. Migraines frequently require specific medications like triptans, gepants, or prescription-strength drugs for effective treatment. Additionally, frequent use of OTC pain relievers can lead to medication overuse headaches (MOH), or “rebound” headaches.
2. Myth: You should only take migraine medication during an attack.
Fact: There are two main types of migraine medications: abortive (acute) and preventive. Abortive medications are taken at the onset of a migraine to stop or reduce symptoms, while preventive medications are taken daily or regularly to reduce the frequency and severity of migraine attacks. Many people mistakenly believe migraine medications are only for acute treatment, missing out on the benefits of preventive therapy.
3. Myth: If a migraine medication doesn’t work once, it will never work.
Fact: Migraine medications, especially abortive ones like triptans, may not work every time. Factors like how early the medication is taken, dosage, and accompanying symptoms can influence effectiveness. It’s essential to take medication as soon as migraine symptoms start, and sometimes trying a different formulation (e.g., nasal spray vs. pill) or adjusting the dosage may make a difference.
4. Myth: Stronger medications are always better.
Fact: Stronger medications like opioids or barbiturates are not recommended for migraine treatment. While these drugs might relieve pain temporarily, they can cause dependence, medication overuse headaches, and other long-term problems. Triptans, CGRP inhibitors, and NSAIDs are generally safer and more effective migraine-specific treatments than narcotics.
5. Myth: Migraine medications are addictive.
Fact: Most migraine-specific medications, like triptans, gepants, and CGRP inhibitors, are not addictive. While certain pain medications like opioids can lead to dependency, they are not commonly prescribed for migraines and should be avoided. It’s important to differentiate between proper migraine medications and narcotics.
6. Myth: Preventive medications stop all migraines.
Fact: Preventive medications are designed to reduce the frequency and severity of migraines, but they typically don’t eliminate them entirely. They are usually prescribed to people who have frequent or severe attacks (e.g., more than 4-5 per month). Even with preventive medication, migraines may still occur but can be milder or less frequent.
7. Myth: You should stop taking preventive medication if you feel better.
Fact: If preventive medication significantly reduces migraines, it doesn’t mean the underlying condition is gone. Stopping preventive medications without consulting a doctor can lead to a return of frequent and severe attacks. Any changes to medication regimens should be guided by a healthcare professional.
8. Myth: All migraine medications have severe side effects.
Fact: Many migraine medications have mild or manageable side effects, and newer drugs like CGRP inhibitors (e.g., Aimovig, Emgality) are designed to minimize side effects. Not everyone experiences adverse effects, and those that do are often mild and temporary. If side effects occur, working with a doctor to adjust the dosage or switch medications can improve tolerance.
9. Myth: You should avoid taking medication unless a migraine is severe.
Fact: Waiting for a migraine to become severe before taking medication can reduce the effectiveness of treatment. Most migraine medications, especially abortive ones like triptans or NSAIDs, work best when taken early, at the first sign of a migraine. Delaying treatment often makes it harder to relieve the symptoms.
10. Myth: Botox is only for cosmetic purposes, not migraines.
Fact: Botox is an FDA-approved treatment for chronic migraines (15 or more migraine days per month). It works by blocking the release of certain chemicals involved in pain transmission. Though it was originally developed for cosmetic purposes, it has proven effective in reducing the frequency and severity of chronic migraines.
Conclusion:
There are many misunderstandings about migraine medications, from when and how to take them to their potential side effects. Effective migraine management often involves finding the right medication regimen, including both acute and preventive options, and taking medications early in an attack. Consulting with a healthcare provider is key to overcoming these misconceptions and developing a personalized treatment plan.
