For patients who have migraines fairly often (let’s say: once a week – often in our field, we’ll look at whether or not they have 4 days a month of significant migraines that really impact the quality of their life) then for these patients, they’re smarter to get on medicines that prevent the migraine as opposed to using the medicines to treat it once it’s happened – to what we call abort the migraine or abortive medicine. Primary care doctors, neurologists, pain doctors – lots of doctors can help patients find medicines that might prevent the migraine. There’s a variety of medicines that are used for this. One of the nice things about preventing the migraines is that it doesn’t trigger these rebound headaches that can occur with the short acting abortive medicines. For the rare headache (once a month, maybe twice a month) abortive medicines are okay, but when they’re used frequently, they really have the problem of developing these rebound headaches – increased vulnerability to a headache as soon as the good effects have worn off. Included in this are Tylenol, Ibuprofen, Naproxen, Aleve, Fioricet, Fiorinal, the Triptan medicines, medicines like Imitrex, etc. There are many different medicines that are short acting for the purpose of aborting the pain of a headache, and if they’re used very sporadically, they too can be good, but when they’re used frequently, they increase the headache problem.
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