Some Medications Used to Treat Migraines

Type

Examples

Some Side Effects

Prevention

Antiseizure medications

Divalproex

Valproate

Hair loss, stomach upset, liver dysfunction, a tendency to bleed, tremors, and weight gain

Not used in pregnant women with migraines

Weight loss, confusion, and depression

Beta-blockers

Spasm of the airways (bronchospasm), an abnormally slow heart rate (bradycardia), fatigue, insomnia, worsening of heart failure, and sexual dysfunction

Changes in blood sugar levels (possibly making it difficult for doctors to know when blood sugar levels become too low in people with diabetes)

With some beta-blockers, unfavorable effects on lipid (fat) levels

A botulinum toxin (used to block nerve activity)

Neck pain and stiffness

Weakness of muscles in the face and sometimes the neck

Calcium channel blockers

Dizziness, low blood pressure, and weakness

Constipation

Ditans*

Dizziness and drowsiness

Monoclonal antibodies

Pain and irritation at the injection site and constipation

Very rarely, allergic reactions

Tricyclic antidepressants

Drowsiness, weight gain, increased heart rate, dry mouth, confusion, and constipation

Treatment of severe migraines

Antiemetic medications (used to relieve nausea)

Low blood pressure, drowsiness, involuntary movements, and muscle spasms

Ergot derivatives

Medication overuse headache (rebound headache) if the medication is taken too frequently

Nausea, vomiting, and minor muscle cramping

Rarely, chest pain due to an inadequate blood supply to the heart muscle (angina)

Gepants*

Minimal

Triptans (5-hydroxytryptamine [5-HT], or serotonin, agonists)

Medication overuse headache if the medication is taken too frequently

Flushing, tingling, dizziness, drowsiness, nausea, and a sense of pressure or pain in the throat or chest

Opioids

Medication overuse headache if the medication is taken too frequently

Slowing of breathing, constipation, retention of urine, drowsiness, and nausea

Treatment of mild to moderate migraines

Analgesics

Medication overuse headache if the medication is taken too frequently

Occasionally rash

Antiemetic medications

Low blood pressure, drowsiness, involuntary movements, and muscle spasms

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Medication overuse headache if the medication is taken too frequently

Gastritis (inflammation of the stomach) and peptic ulcers

* Ditans can also be used to treat mild to moderate and severe migraines.

† Opioids should be used as a last resort when migraines cause severe pain and other measures are ineffective.