Currently, there is no cure for migraine, and preventive treatment rarely prevents all migraine attacks. As a result, it is important for people with migraine to talk with their clinician about acute treatment options, also known as abortives. An attack-based care approach recognizes that not all migraine attacks are the same. Treatment plans may differ based on many different factors including: the timing of the attack, the pain level, the symptoms, the triggers, and your responsibilities that day. All of these play a role in how you might best treat a migraine attack. For example, if you are throwing up then an oral medication might not be your best option for treatment.
We encourage you to download our Migraine Treatment Toolbox as well as our fillable Migraine Action Plan, then work with your clinician to find the best treatment options for you.
Many of us may have similar migraine-related symptoms like head pain and nausea, but we know that no two people will experience migraine attacks in exactly the same way. With each attack, some people experience the same symptoms. Other people may experience bewildering changes in symptoms from attack to attack. It’s important to identify all four phases of migraine (Prodrome, Aura, Attack and Postdrome), and to initiate treatment as early as possible. CLICK HERE to learn more about treatment options based on symptoms.
How you treat your migraine attack depends on if you are in the beginning, middle, or full-blown stage of an attack. Catching a migraine attack when it first starts and treating it properly can keep it from getting worse. If you have a full-blown attack that includes symptoms such as vision impairment, dizziness, vertigo, and vomiting, you may need a totally different treatment plan for more intense symptoms. Work with your doctor to develop an attack-based care management plan that includes treatments for different stages of migraine attacks. CLICK HERE to learn more about treatment options based on timing.
Sometimes migraine attack pain increases slowly over time. Other times, attacks can go from level 1 to 10 in just minutes. Where you are on the pain scale will help you decide how to treat your attack. There are many attack-based care treatment options available. Knowing which migraine treatment to use when your pain level is low versus when your pain level is high can be challenging. It’s important to talk with your doctor ahead of time about what you should take, when a second dose might be allowed, and when you should consider going to a more aggressive rescue plan. CLICK HERE to learn more about treatment options based on pain level.
It's hard to pinpoint migraine triggers, which is one of the most difficult aspects of migraine life. As a matter of fact, some triggers can result in more resistant attacks, faster escalating attacks, or more debilitating attacks, while others tend to result in less severe attacks. Knowing what triggered your migraine attack can help you quickly determine an attack-based care treatment plan. In some cases, the best treatment is rest and over-the-counter medications. In others you may be able to abort an attack with a medical device. And in still others you may need to jump straight into your full-strength rescue medication and adjust activity. CLICK HERE to learn more about treatment options based on triggers.
When it comes to migraine, it can be overwhelming to think about responsibilities. It may not be feasible to take certain treatments based on our life responsibilities at any given time. Understanding when pushing through an attack can worsen or prolong it, versus stopping and cancelling plans, is one of the greatest challenges of managing migraine. Working, driving, and taking care of children can all take priority over treatment at times, but there can also be consequences to that and increase the risk of an attack lasting a long time, or the disease chronifying. In addition, all medications come with warnings, and the potential side effects vary greatly. For instance, a medication may make you sleepy and unable to drive, or you may not be able to take care of very young children. Talk with your doctor about how to manage life responsibilities with appropriate migraine treatments. CLICK HERE to learn more about balancing treatment options and responsibilities.
1. When is the best time to treat a migraine attack with a medical device?
There are six FDA-cleared medical devices, four of which are available only by prescription (learn more HERE).
- Acute treatment of migraine with medical devices is best started early in an attack, ideally within the first 30-60 minutes.
- They are an ideal first-line treatment to use with adolescents to avoid use of medications that have not completed clinical trials for people under 18 years old.
- Medical devices can be used in combination with acute medications.
2. When should I consider a non-oral medication for an attack?
While everyone experiences migraine attacks slightly differently, and likely even has more than one type of attack themselves, there are a few common factors that make achieving our treatment goals challenging. The following 4 scenarios are ones where you should consider asking your clinician about a non-oral medication:
- Nausea and Vomiting
- Gastroparesis
- Wake-Up Migraine
- Fast-Escalating Migraine Attack
3. Can I treat an attack during the prodrome phase before the pain starts?
In general it is best to treat an attack as early as possible, however there is at least one medication, Ubrelvy, that has shown efficacy when used during the prodrome phase. In this situation, it is important to know what your prodrome symptoms are so that you can treat early and try to avoid the migraine going to the attack phase.
More FAQs coming soon!Â
Let us know if you have an FAQ we should add to this page
Download and print our Attack-Based Care Guide!
Use it to help you figure out how best treat your next attack. You can also bring it to your next doctor's appointment and ask your doctor which options would be good to add to your personal migraine treatment toolbox.
Many thanks to our industry partners for their support of this educational project on acute migraine care
