By Pooja Aggarwal, MD, as told by Kara Meyer Robinson
As a board-certified neurologist who treats migraines — and someone who gets migraines regularly — I feel your pain.
About 2-3 times a month, I get full-blown migraines in the back of my head. It also comes with photophobia, or sensitivity to light, and floaters in my vision. When I get a migraine, it can last for 6-8 hours.
Between the migraines I have and the ones I treat in my practice in Orlando, Florida, I’ve become pretty adept at managing them.
But just because some things help me doesn’t mean they will help you. Different people have different types of migraines, and this affects what works and what doesn’t.
First, know your triggers
Everyone’s motives are different. It is important to be able to identify and avoid your own personal triggers.
Mine include stress, lack of sleep, dehydration, skipping meals, and having a glass of red wine. (Yes, just one is all it takes.)
Yours may be different. Common triggers include:
- some smells
- Certain types of light
- Eating too much
- food additives
- Time difference
- loud sounds
- Sun light
- Your period
Once you know your triggers, you can do your best to stay away from them. This may reduce how often you get migraines, how bad they are, or even prevent them before they start.
How to manage triggers
To stay on top of my migraines, I always try to stay hydrated, exercise regularly and avoid skipping meals.
Dehydration can trigger migraines. It may also make your migraines last longer. To maintain your water supply, try to drink at least 64 ounces of water daily.
If hunger motivates you, try eating three set meals a day.
Lack of sleep can also trigger migraines and make them last longer. Tell migraine patients to sleep at least 7 hours each night.
I also take 400 milligrams (mg) of magnesium each day. Magnesium oxide is best for treating migraines and can reduce their frequency and severity. It helps me, but it doesn’t help everyone. If you have frequent or severe migraine headaches, magnesium may not work for you.
Editor’s note: Check with your doctor before you start taking the supplement, to make sure it’s a good option for you.
When a migraine strikes
As soon as a migraine appears, the first thing I do is drink fluids and eat something.
I also take medicine. I usually take 400mg of ibuprofen, which helps with the pain. You can also try over-the-counter medications such as Excedrin Migraine or Tylenol.
But be careful. Taking too many medications for migraines can make it worse.
Excessive use of acetaminophen, ibuprofen, naproxen, or other pain medications can lead to medication overuse. This is similar to a daily chronic headache or migraine. This may happen if you take one of these medicines 2-3 days a week for several weeks.
Again, keep in mind that some treatments work for some people and not others. There are a lot of options, so talk to your doctor to find what works for you.
Your doctor may suggest some medications that may stop severe migraines if you take them at the onset of a migraine. They include:
- Almotriptan Malate (Accort)
- eletriptan hydrobromide (Relpax)
- Frovatriptan (Frova)
- Lasmidtan (Refov)
- naratriptan (Amerg)
- rizatriptan benzoate (Maxalt)
- sumatriptan succinate (Imitrex)
- zolmitriptan (Zomig)
They may also recommend medications to help prevent migraines, such as:
- galcanezumab (Egality)
- Remigipant (Nortec)
- Sodium valproate (Depakote)
- topiramate (Topamax)
- Ubrogepant (Ubrelvy)
Other things to try
If you suffer from frequent migraines, Botox injections may help. Botox is a drug that blocks the neurotransmitters that carry pain signals from your brain.
Botox relieves migraine pain for some people but not for others.
I haven’t tried it because my migraines are not frequent enough. It’s best for people who suffer from chronic migraines, or 15 headache attacks a month.
You can also try alternative treatments like these:
- Yoga and meditation can help relieve stress and reduce migraines.
- Massaging the scalp or face can help relieve pain.
- Acupuncture may help reduce the number of migraines you get or help them be more mild when they do.
When a migraine is uncomfortable for me to be near a light, it usually lasts about 20-30 minutes. I can sit in a room with the lights off, and they disappear.
I’m lucky – it’s fast for me. But it varies from person to person.
If you are sensitive to light when you have a migraine, try to stay in a cool, dark room. You may need to wear an eye mask as well.
One last thing: Talk to your doctor about the type, severity, and frequency of your migraines. They can tailor your treatment to your personal needs.