Migraines and Other Headaches

In considering treatment for your headaches, a doctor may prescribe medicines that will relieve accompanying symptoms as well as the pain in your head. Be sure to start out taking the smallest amount of medication that works.

Nonprescription Medications

A doctor will probably suggest that you first try nonprescription (over-the-counter) medications. Take them at the first sign of a headache. These include acetaminophen (Tylenol) or ibuprofen (Advil, Nuprin, or Motrin). People under the age of fifteen should not use aspirin because of the danger of Reye's syndrome, an illness that causes severe vomiting and possibly coma. Other types of headache relievers are the nonsteroidal anti-inflammatory drugs (NSAIDs). These include naproxen sodium, sold over-the-counter as Aleve.

Prescription Medications

If you need something to relieve the nausea and vomiting caused by your migraines, the doctor may prescribe antiemetics, such as Promethazine (Phenergan) or prochlorperazine (Compazine). Both are available by mouth (for nausea) or by suppository (in case of vomiting). Another antinausea medication is metoclopramide (Reglan), which is available by mouth or, if necessary, by intravenous injection (IV).

For a full-blown headache, doctors sometimes prescribe a combination drug. Three medications— isometheptene mucate, a vasoactive agent; dichloralphenazone, a nonbarbiturate sedative; and acetaminophen, a painkiller—are all present in Midrin. Fioricet and Esgic are trade names for another combination: acetaminophen for pain relief; butalbitol for sleep; and caffeine.

For teens with severe headaches, doctors may prescribe ergotamine tartrate (Cafergot or Wigraine), a medication that constricts the blood vessels to prevent future blood vessel dilatation. Tablets called Ergomar or Ergostat are available for absorption under the tongue for those who are experiencing vomiting. An ergotamine nasal spray, Migranol, is also available. Sometimes, especially in the emergency room, doctors may use dehydroergotamine (DHE 45) by injection or intravenously.

A blessing for some migraine sufferers is the newer triptan category of medications. One example is sumatriptan (Imitrex), which is available in tablets, by injection, or by nasal spray. Although the nasal spray is effective, it leaves an unpleasant aftertaste. Other triptans include naratriptan (Amerge) and rizatriptan (Maxalt). One drawback is that these new medications are expensive.