What are acute medications for migraine?

Acute medications - sometimes referred to as acute abortive medications -
are used to treat the pain of the headache after it has started. Examples of
acute abortive medications include over-the-counter medications, NSAIDs,
ergots, and triptans.

The Food and Drug Administration (FDA) has approved three over-the-counter
products to treat migraine. Excedrin® Migraine (a combination of aspirin,
acetaminophen and caffeine) is indicated for migraine and its associated symptoms.
Advil® Migraine and Motrin® Migraine Pain, both ibuprofen medications, are
approved to treat migraine headache and its pain.

The use of other prescription anti-inflammatory agents may be effective for
some migraines. These agents may have gastrointestinal side effects, which
limit their use since larger than normal doses may be required to treat the
migraine attack.

Migraine-specific therapies are designed specifically to treat migraine attacks.
Ergotamine preparations are no longer readily available. Dihydroergotamine (DHE)
may be used for self-injection. DHE is also available as the nasal spray Migranal.
A combination product containing isometheptene (Midrin®) is not usually effective
for migraine. Sumatriptan (Imitrex®), a 5-HT agonist, is available in self-injectable,
nasal spray and rapidly-dissolving tablet forms. Other 5-HT agonists are almotriptan (Axert®),
naratriptan (Amerge®), rizatriptan (Maxalt®), zolmitriptan (Zomig®), frovatriptan (Frova®)
and eletriptan (Relpax®). All are available in tablet form. Both rizatriptan and
zolmitriptan are available in an orally disintegrating tablet (Maxalt-MLT and Zomig-ZMT),
which can be taken without water. Zomig also comes in a nasal spray.

Acute medications are most effective when taken early in an attack, while the pain
is still mild and before skin sensitivity increases. The goal is complete relief of pain
and associated symptoms, allowing the sufferer to quickly return to normal functioning.