My doctor prescribed me medications to treat my migraine attacks…but they don’t work! Sounds familiar? You may be treating too late.  

I have been told to wait until my pain is really severe to take my meds. Isn’t that the right thing to do? 

No, it’s not! Think of a migraine attack as a fire (it is an inflammation after all). It is easier to control a small fire than a big one! Research has shown that treating the migraine attack early increases the chances of success by 40%! 

treat early PPT

Almost every patient with migraine will initially use their acute medications too late, for many reasons. Here are some of the very common reasons leading to a delay in intake, and some tips on how to treat earlier. Can YOU increase your success rate? Record your results in your diary https://migrainetracker.ca/

Problem: I’m not sure it’s a migraine

Fix: observe your pattern and try treating a possible attack

Migraine attacks starts in all sorts of ways. It’s not always easy to be sure that a migraine is starting. Observe yourself. But sometimes…you know it’s a migraine but you don’t want to admit it. Don’t let false hope keep you from treating on time.

Problem: I do not have my meds with me 

Fix: get a migraine kit 

It’s a common problem. You need to make a migraine kit. Put your meds in a little pouch or box. Carry it with you. Have another one in your car or at work. Make sure you have enough medication, including when you travel (LINKIN Travel 1107). If you live with migraine, attacks will happen: be prepared to fight back!

Problem: My attacks start really fast, or I wake up with them, or I have nausea and I throw up

Fix: ask your health care provider for more options

There are medications that work quickly, like nasal sprays, injections etc. See our other handout on this topic (See this post). 

Problem: I am afraid of side effects

Fix: try, observe, and ask for more options 

All medications can have side effects. Try what you have been prescribed.  If there are troublesome side effects, then discuss other options with your health care provider. It may take a few different trials to find what works best for you.

Problem: The pills are costly 

Fix: ask for more affordable options and evaluate the benefit

Medications can be costly. If they are effective, consider buying them in a larger amount to save on pharmacy dispensing fees. Shop for the pharmacy with the best deal. Make sure you get the generic options. And finally, weigh the cost of the medication against the cost of a lost day, then make the decision that is best for you. 

Problem: I have been told to avoid overuse

Fix: Use a headache diary

If you have 10 days or less of headaches requiring treatment per month, the risk of chronification by overuse is low (See this post). If you do have more than 10 days per month, then keep a diary. Start a preventive agent. Try not to treat the milder headaches so that you can treat on more severe days. See our information on non-medication strategies and apply a combination approach. This is a tricky situation to be discussed with your health care provider. 

Conclusion: Treat early, save the day! 

By changing your way of using your meds, you may have better results and endure less pain. 

You’re not convinced? Do your own experiments. Try to treat a few attacks early and see if it works better for you. 

See our Don’t let a migraine ruin your day! video

REFERENCES

Gilmore B, Michael M. Treatment of acute migraine headache. Am Fam Physician. 2011;83(3):271-80.

Lanteri-Minet M, Mick G, Allaf B. Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study. Cephalalgia. 2012;32(3):226-35.

Valade D. Early treatment of acute migraine: new evidence of benefits. Cephalalgia. 2009;29 Suppl 3:15-21.

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