Depending on the frequency and severity of migraines, there are a variety of treatment options.
First of all, we like to separate out PREVENTIVE (prophylactic) medications, which take a longer time to work, but typically work to prevent migraines; from RESCUE (abortive) medications, which work rapidly to stop a headache in its tracks. If you have infrequent or episodic migraines, less than twice a week, you may only need an effective rescue medication, which ranges from over-the-counter options such as naproxen, acetaminophen, or ibuprofen, to prescription medications such as a triptan or one of the newer CGRP antagonists - Ubrelvy or Nurtec. Dr. Chalfin has samples of Ubrelvy and Nurtec in her office to share for you to try.
But if you're having at least 1-2 headaches per week, if they last a long time or are very debilitating, or if they don't respond to rescue treatments, I would strongly consider a PREVENTIVE treatment option.
I like to think about preventive treatments for migraine as fitting into one of 3 tiers: the minimally-invasive LIFESTYLE CHANGES tier, the "natural" SUPPLEMENT tier, and the PHARMACEUTICAL tier. Of course, you can pick and choose treatments from more than one tier.
The simplest, though sometimes the hardest, treatment option is to make some lifestyle changes: avoid your triggers, cut out any pain meds to no more than 1-2 times per week, wean off all caffeine for at least 2 months, drink at least 64oz/day of water, eat a diet rich in fruits and vegetables, get at least 150 minutes of moderate-intensity exercise per week, prioritize sleep hygiene and getting at least 7-8 hours of rest per night, and implement relaxation and stress relief strategies. I know, easier said than done. Though these interventions won't cure every migraine sufferer, they are likely to at least help, and they are unlikely to hurt.
In the next tier, we have the supplements. These are less effective and not regulated. Popular options include magnesium oxide 400mg daily, riboflavin (vitamin B2) 400mg daily, and coenzyme Q10 400mg daily. You can also purchase a prepackaged supplement made just for migraine, such as PreventaMigraine, which has been helpful to some people.
Finally, in the pharmaceutical tier, you have the most studied and the most regulated - the prescription medications. We have the classic meds we've used for decades, mainly borrowed from other disease conditions - antihypertensive meds such as propranolol or metoprolol, antidepressants such as amitriptyline or venlafaxine, and anticonvulsants such as topiramate and valproic acid. And then we have the newer medications that were targeted specifically against CGRP, the protein involved in migraines; these include the oral agents Qulipta and Nurtec or the one-monthly injectables Ajovy, Aimovig, or Emgality.
Whatever you do, you have options. Dr. Chalfin can help you tease through these and pick the one(s) that's right for you.
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