Many people with primary headaches—those not caused by an underlying health condition—can control their symptoms with medication. NYU Langone experts can develop a personalized medication plan to address and prevent headache attacks.
Medication prescribed for headaches falls into one of two categories: preventive, which means it’s taken on a daily basis to decrease the frequency of headaches, or acute, meaning it’s taken during a headache to counteract the pain.
Acute medications are taken only during the onset of a headache attack. These medications are taken at first sign of headache to shorten the attack by relieving the pain and associated symptoms. Acute medications fall into two categories—specific and nonspecific. Nonspecific medications are those that can be used to treat pain, nausea, or vomiting from any cause. These include both prescription and over-the-counter medications such as nonsteroidal anti-inflammatories, or anti-nausea medication.
Specific medications are designed to treat the headache and associated symptoms for migraine or cluster headache. These prescription drugs include classes of medications called triptans and dihydroergotamine. These medications are available in different formulations and can be tailored to a person’s individual symptoms. Injections and nasal sprays are also useful for people who have headaches that are accompanied by nausea and vomiting.
Preventive medications are taken on a daily basis to reduce the frequency of subsequent headaches. Several classes of medications, including those initially developed for treating high blood pressure, epilepsy and seizure disorders, or depression, can effectively reduce headache frequency. Preventive medications usually do not require a lifetime commitment. Many people can gradually decrease medication after 6 to 12 months of use without a recurrence in headache frequency and pain, while others require long-term treatment.
If you require preventive medications, your physician monitors your progress and adjusts the dosages during ongoing follow-up visits to provide optimal pain relief and to minimize side effects. Some medications require blood tests at periodic intervals.
If you experience acute headaches that fail to respond to medication, migraine attacks that last three days or longer despite appropriate therapy—also called status migrainosus—or migraine associated with significant nausea and vomiting that prohibits the use of oral medication, your doctor may recommend intravenous (IV) medications.
Our doctors administer IV medications for all patients at our state-of-the-art infusion suite, located at the Preston Robert Tisch Center for Men’s Health. A headache specialist determines if infusion therapy is appropriate, and refers you for treatment. Sessions typically occur in the morning and can last for several hours. Different medications delivered by an IV are used help treat the headache. These medications are administered by an infusion nurse, and the treatment plan is monitored by one of our headache specialists during the procedure.