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Treating Migraine : Over-the-counter Abortive Therapy

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Q: What are the most effective over-the-counter medications to stop a migraine attack?
A: Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are particularly helpful once central sensitization has started. It is important to avoid overusing these medications since you could develop gastrointestinal or kidney problems.
Q: How do aspirin and the other NSAIDs work to treat a migraine attack?
A: Aspirin and the other NSAIDs are considered a specific treatment because they treat the process of the migraine attack, not simply the pain of the headache. It is thought that their anti-inflammatory properties work at the brain cell level or block chemical release at nerve endings, preventing the inflammation and dilation of blood vessels.
Q: How do I know if I am taking too much aspirin or other NSAIDs for my migraine attacks?
A: If you are using aspirin or another NSAID more than twice a week for your attacks, then you are taking too much. Migraine attacks aborted with any kind of therapy should not occur more than twice a week or you can progress to chronic daily headache. It is not enough to use abortive therapy for migraine; you must have preventive care too.
Q: Can my child take an NSAID or aspirin for a migraine attack?
A: Aspirin is not recommended for those under 18 because of the potential for Reye syndrome, and acetaminophen might cause medication overuse headache. However, children and teenagers may use other NSAIDs for migraine attacks. Consult your doctor about the proper dose for your child.

Specific over-the-counter treatment

The most effective over-the-counter medications for aborting a migraine attack are aspirin, ibuprofen, and naproxen sodium. These nonsteroidal anti-inflammatory drugs (NSAIDs) block the chemical reaction in the body that produces inflammation. Originally used to treat the inflammation and pain of arthritis, these medications have now been found to be very helpful in treating many illnesses, including migraine attacks. These medications do not simply treat the pain of a migraine attack but stop the process of the attack. If the migraine is not successfully aborted within 2 hours or less using aspirin or another NSAID, then these medications need to be combined with specific migraine abortive therapy (either triptans or dihydroergtamine) which is only available on prescription.

Over-the-counter NSAIDs
  • Aspirin 1,000mg

  • Ibuprofen 600–800mg

  • Naproxen sodium 440–660mg (available over-the-counter in the US but may require a prescription in some other countries)

Safe use of NSAIDs
  • To avoid gastrointestinal upset, NSAIDs should be taken with food and a large glass of water.

  • The overuse of NSAIDs can cause stomach problems and should be avoided if you have medical problems associated with gastrointestinal bleeding or ulcers, or if you are taking medications that interact with NSAIDs (ask you doctor if you are not sure).

  • The NSAIDs, apart from aspirin, can complicate high blood pressure and heart disease; do not use these drugs without consulting your doctor.

  • As with all over-the-counter medications, if you have other chronic medical conditions you should never self-medicate with anything before consulting your doctor.

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