Understanding migraines
6/12/2025 by Jasmine King, Pharm.D.
Migraines are severe headaches that often come with nausea, sensitivity to light or sound, and sometimes even vision problems. They can last for hours or even days.
Migraine prevention vs. treatment
There are two main ways to manage migraines: prevention and treatment.
- Prevention means taking steps to stop migraines before they start. This approach could involve medications, lifestyle changes or identifying things that bring on a migraine.
- Treatment is what you do when a migraine starts. These medications work to reduce the pain and other symptoms while migraines are happening.
Both prevention and treatment are essential parts of managing migraines, and your clinician can help you determine which options are best for you.
Common medication options
- Prevention medications
- Beta-blockers: metoprolol or propranolol.
- Antidepressants: venlafaxine ER (Effexor XR) or amitriptyline.
- Anti-seizure medications: valproate or topiramate.
- CGRP inhibitors: fremanezumab (Ajovy), galcanezumab (Emgality) and erenumab (Aimovig).
- In some cases, Botox injections are used to prevent chronic migraines.
- Treatment medications
- Pain relievers: Over-the-counter options like ibuprofen or acetaminophen.
- Triptans: These are prescription medications that are highly effective at stopping a migraine once it starts. Examples include rizatriptan (Maxalt) or sumatriptan (Imitrex).
- Anti-nausea medications: If nausea is a problem, your clinician might suggest medications to help, such as metoclopramide (Reglan).
- CGRP inhibitors: Examples include ubrogepant (Ubrelvy), rimegepant (Nurtec) and zavegepant (Zavzpret).
Side effects and when to talk to your clinician
It's important to talk to your clinician or pharmacist if you experience any side effects from the medication, especially if they last or become bothersome. You should also contact them if you:
- Notice your migraine medications are no longer working as well as they used to.
- Have any unusual or severe reactions to your medication.
- Are pregnant, planning to become pregnant or breastfeeding, as some migraine medications can affect pregnancy.
- Have other health conditions like high blood pressure or heart disease, as some medications may not be safe for you.
Jasmine King, Pharm.D., is a pharmacy resident in ambulatory care at Mayo Clinic in Rochester. She will train at several Primary Care in Rochester and Kasson outpatient sites.