By Korin Miller
When a migraine strikes, it can feel like your brain has completely turned against you. Cue wearing sunglasses indoors, booking it in the opposite direction of any kind of noise, and possibly curling up into the fetal position until it’s all over.
As you struggle through a migraine, you might wish you could snap your fingers (softly, somehow without moving) and conjure up a neurologist for guidance, ideally one who has experienced those uniquely excruciating migraines firsthand. With that in mind, we talked to several neurologists about how they prevent and treat their own migraines. Everyone’s migraines are different, and the best treatment for each person is pretty individual. Still, you might learn something from these experts that can help you combat your own migraines.
- Taking over-the-counter medications
Several doctors we spoke to mentioned fighting migraines with medications you can easily find on drugstore shelves, like aspirin, acetaminophen, or anti-inflammatory drugs.
Daniel Franc, M.D., Ph.D., a neurologist at Providence Saint John’s Health Center in Santa Monica, California, has migraines that come with sound and light sensitivity. He turns to the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen when he feels a migraine coming on, he tells SELF. And Hsinlin Cheng, M.D., Ph.D., director of the Headache and Neuropathic Pain Unit at Massachusetts General Hospital, tells SELF he opts for aspirin or acetaminophen to stave off his migraines, which start with neck and shoulder tightness, followed by light and noise sensitivity and a throbbing head. “The pain is excruciating,” he says.
There are a few reasons why these drugs are considered first-line defenses against migraines. Unsurprisingly, NSAIDs can tamp down on the inflammation implicated in migraines, thereby reducing pain, according to the National Institute of Neurological Disorders and Stroke (NINDS). Aspirin inhibits prostaglandins, a group of chemicals that have hormone-like effects and may promote migraines, Amit Sachdev, M.D., an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University, tells SELF. Doctors aren’t entirely sure why acetaminophen works to alleviate migraines. However, there is a theory that it may reduce prostaglandins’ effects as well, Dr. Sachdev says.
There are also migraine meds out there specifically formulated to combine these drugs with caffeine, which brings us to the next item on our list.
- Having a little caffeine
Having too much caffeine is a common migraine trigger, according to the Mayo Clinic. But the Mayo Clinic also points out that in “small amounts,” caffeine can help relieve migraine pain in the early stages. It can also help enhance the pain-fighting effects of acetaminophen and aspirin, the organization says.
When you have a migraine, the blood vessels in your brain tend to enlarge, and caffeine can work to narrow those blood vessels, Dr. Franc explains. Because of this, he will “slam coffee for the caffeine” if he senses a migraine is coming, he says. Ditto for Dr. Sachdev, who says he’ll drink coffee or a caffeinated soda when he feels a migraine coming on, or take a migraine drug that combines aspirin, acetaminophen, and caffeine.
If you’re not sure whether or not caffeine might help your migraines, you don’t want to dive headlong into a huge pot of coffee when you feel one coming. Try a little bit at first, like half a cup of coffee or black tea, to see if that helps, Dr. Franc says. Or take the recommended dose of a migraine-relieving drug that contains caffeine instead.
- Getting regular sleep
Poor sleep habits can bring on migraines in some people, according to the Mayo Clinic. Dr. Sachdev knows this all too well. He tells SELF that he tries to get adequate sleep to help stave off migraines, and when he doesn’t, he can feel a dull ache start up behind one eye, signaling that a migraine is on its way.
This is also a problem for Kevin Weber, M.D., a neurologist at The Ohio State University Wexner Medical Center. “If I get too much sleep, too little sleep, or change time zones or sleep patterns, I am at very high risk for a migraine,” he tells SELF.
Clearly, the link between good sleep and fewer migraines is strong for some people, but the mechanism behind it isn’t really understood, Dr. Sachdev says. In any case, adults typically need between seven and nine hours of sleep each night, so do your best to stay within those bounds. The NINDS also recommends that people with migraines try to set regular sleep hours by waking up and going to bed at the same time every day, even on weekends. Obviously, that can be easier said than done, but if shoddy sleep is a clear migraine trigger for you, focusing on this area can be well worth it.
- Taking vitamin B regularly
The U.S. National Library of Medicine says that taking riboflavin, a B vitamin, seems to reduce the number of migraine headaches by about two attacks a month in some people.
Doctors aren’t 100 percent sure why riboflavin (which is an essential dietary nutrient) may help, but mitochondrial dysfunction may have something to do with it. Mitochondria are essential components of your cells that help with your energy production, and it’s thought that mitochondrial dysfunction may play a role in migraines, according to the National Institutes of Health. Riboflavin is necessary for proper mitochondrial function, so researchers are investigating whether or not it can help prevent or treat migraines.
Dr. Cheng does find that taking a mix of B vitamins including riboflavin is helpful in preventing his migraines. “I take it every morning,” he says. With that said, this is still an emerging area of research. There’s not yet a ton of scientific evidence to back this one up, and you should always talk to your doctor before introducing any vitamins into your routine anyway. Bring this one up at your next appointment before giving it a try.
- Eating a snack
In more migraine unfairness, not eating often enough can trigger symptoms. “I get migraines if I skip a meal, so I desperately try to avoid that,” Dr. Weber says.
Eating at around the same time every day, making sure you don’t skip meals, and taking a pass on any kind of fasting might help prevent your migraines from cropping up, the Mayo Clinic says. In addition to taking aspirin or acetaminophen, Dr. Cheng will eat a snack if he feels a migraine approaching. “That is usually enough to prevent a full-blown migraine,” he says.
Eating regularly won’t necessarily help if your meals are full of things that can induce migraines. The Mayo Clinic lists aged cheeses, salty items, and processed foods as some of the most common migraine triggers, so remember that as you decide how to fuel your mind and body.
- Taking prescription medications
Some prescription migraine drugs are meant to relieve pain in the moment. For instance, Dr. Weber relies on naratriptan for help with his migraines. This drug belongs to a group of popular migraine medications called triptans, which increase the amount of serotonin in your brain, helping your blood vessels to constrict and reducing pain, according to the NINDS. It can also help with nausea, vomiting, sensitivity to light, and sensitivity to sound, the Mayo Clinic says. Another common class of migraine drugs is ergots, which decrease your body’s transmission of pain messages.
Others drugs, like erenumab-aooe, are supposed to stop migraines from even starting. In exciting news for some people with migraines, in May 2018 the U.S. Food and Drug Administration (FDA) approved the use of erenumab-aooe to prevent migraines. It works by blocking the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks.
There are lots of prescription migraine treatments out there, so talk to your doctor if you’re interested in exploring your options.
- Acting as soon as you notice symptoms
“If I catch it early, I can knock it out,” Dr. Franc says. “But if I let it go for an hour or more, I’m stuck with it for the rest of the day.” If that sounds exactly like your experience, make sure to keep whatever helps prevent or treat your migraines with you at all times. That way, the moment you feel those telltale symptoms, you can take action against your migraines.