Opioid Pain Medicines
Opioid pain medicines are often prescribed for migraines in people with moderate-to-severe headaches that do not respond to any of the migraine medicines discussed previously. These medicines may also be prescribed to women who are pregnant, as well as to people who have side effects from other medications or who cannot take these other medicines because of other medical conditions.
Examples of opioid pain medicines that may be recommended to relieve migraine symptoms include:
- Butorphanol (Stadol®)
- Meperidine (Demerol®)
- Methadone (Dolophine®, Methadose®)
Preventive Medications for MigrainesYour healthcare provider may recommend taking drugs to help prevent migraines in the first place. Often, migraine prevention medications are recommended when a person has:
- Migraines more than two days per week (or eight days per month)
- Uncommon migraine symptoms, including hemiplegic migraines or migraines with prolonged aura.
A person may also be prescribed preventative medicine when drugs used to treat migraines are:
- Not effective at treating symptoms
- Not recommended because of other health reasons
- Being used more than two times per week.
There are many different medicines that your healthcare provider may recommend. Before making a recommendation, he or she will consider your particular situation, including other medical conditions you may have, previous medicines that you have tried, and your individual needs.
Some examples of medications used to prevent migraines include:
- Propranolol (Inderal®), timolol (Blocadren®), and other beta blockers
- Divalproex (Depakote®), divalproex ER (Depakote ER®), topiramate (Topamax®), and other seizure medications
- Verapamil (Calan®, Verelan®) and other calcium channel blockers
- Amitriptyline (Elavil®), nortriptyline (Pamelor®), and other tricyclic antidepressants
- Methysergide (Sansert®)
To avoid long-term side effects of preventive medications, headache specialists advise people to reduce the dosage of these drugs and then stop taking them as soon as possible. Keep in mind, however, that it may take 2 to 3 months before you notice a decrease in the frequency or severity of attacks, and treatment may be required for 6 to 12 months or longer.
In some cases, your healthcare provider may recommend certain NSAIDs or other antidepressants to help prevent migraines. Antidepressants can be helpful when a person with migraines also has anxiety or depression. Some examples of these types of medicines include:
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®)
- Bupropion (Aplenzin™, Budeprion XL®, Budeprion™ SR, Buproban®, Forfivo™ XL, Wellbutrin SR®, Wellbutrin XL®, Wellbutrin®, Zyban®)
- Venlafaxine (Effexor®, Effexor® XR).