When headaches strike, it’s best to treat them right away. For some migraine patients, over-the-counter medications are sufficient. Sian Spacey, director of the University of British Columbia Headache Clinic, suggests starting with an anti-inflammatory, like ibuprofen (Advil) or naproxen sodium (Aleve), and if that doesn’t work on its own, to combine with acetaminophen (Tylenol). Pregnant women are limited to acetaminophen, however.
The most common prescription medication for migraines are called triptans. There are seven different kinds available in Canada and they go by the brand names Axert, Relpax, Frova, Amerge, Maxalt, Imitrex and Zomig. They work by reversing the changes happening in your brain, and they must be taken early in the migraine to abort the headache.
If you are getting multiple migraines a month and lifestyle changes and other meds aren’t helping, a doctor might suggest taking a daily medication. “Once you have one headache a week or more, the risk of headaches becoming more frequent increases,” says Christine Lay, medical director of the Centre for Headache at Women’s College Hospital in Toronto.
Oral medication options include antidepressants and anticonvulsants, and then there are injectable medications like Botox (most of these are not safe during pregnancy). A specialist can work with you to find the right medication.
Both Spacey and Lay recommend a product called the Cefaly. Lay calls it a “Star Trek” device—it looks like a silver diamond and adheres to your forehead, where it delivers tiny electrical impulses to the trigeminal nerve (a nerve in your brain that plays a role in most migraines). It can be worn during a migraine and to prevent them. There’s also an electrical stimulation armband (the Nerivio) available in the US, but unfortunately it’s not available in Canada yet.
If taken regularly, supplements can help prevent migraines, says Lay, particularly magnesium citrate, vitamin D, vitamin B2 and coenzyme Q10. Speak to a doctor about a supplement plan (especially if you’re pregnant).
If your migraines don’t respond to medications (or if you’re pregnant and unable to take meds), a nerve block can be helpful. A doctor injects a small amount of Marcaine (similar but longer-acting than lidocaine) to the base of the skull to block pain signals from the nerves.