Medical Treatments for Headache & Migraine

First-Line Treatments

Most headache and migraine treatments begin with over-the-counter or prescribed medications, such as:

  • NSAIDs (e.g. ibuprofen)

  • Paracetamol

  • Triptans

  • Ergotamine

  • Anti-emetics (for nausea and vomiting)

Combination medicines, which pair a painkiller with an anti-sickness medication (sometimes alongside a triptan), can also be effective.

Preventive (Prophylactic) Treatments for Migraine

For patients experiencing frequent or disabling migraines, preventive treatment may be recommended. Options include:

  • Topiramate

  • Candesartan

  • Propranolol

  • Gabapentin

  • Riboflavin (Vitamin B2)

  • Amitriptyline

⚠️ Special consideration is required for women of childbearing age, as some prophylactic medications carry potential risks during pregnancy.

Cluster Headache Treatment

  • Oxygen therapy is often used for acute cluster headache attacks.

  • Preventive treatments may include verapamil or transcranial magnetic stimulation (TMS).

Advanced Migraine Therapies

For chronic migraine sufferers who have not responded to standard treatments, additional options include:

  • Botulinum toxin type A (BOTOX®) injections

  • Monoclonal antibodies such as:

    • Fremanezumab

    • Galcanezumab

    • Erenumab (self-administered injection)

CGRP Inhibitors – A New Era in Migraine Care

The discovery of the calcitonin gene-related peptide (CGRP) pathway has transformed migraine treatment.

  • CGRP monoclonal antibodies help prevent migraines

  • CGRP receptor antagonists (e.g. Rimegepant) can both treat and prevent attacks

These therapies represent a major advance in migraine management, offering new hope for patients with resistant or severe migraine conditions.

Read more: NICE approves new acute migraine treatment

✅ At The Health Equation clinics in London & Marlborough, we integrate awareness of medical options with osteopathic and functional approaches, helping patients explore both conventional and complementary pathways for headache and migraine relief.