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Silver Spring, MD
A 27-year-old male asked:

What is the best otc medication to prevent and treat migraine headache?

2 doctor answers3 doctors weighed in
Dr. Paul Grin
Pain Management 37 years experience
NSAIDs: The use of NSAIDs to prevent migraine is usually recommended during those time periods in which a migraine is most likely to be triggered. To lessen the need for acute pharamcologic therapy, prophylactic drug therapy and nonpharmacologic therapies are used. Some patients who experience frequent severe headaches may require both abortive and prophylactic therapy. Hope it makes sense?
Dr. Dariush Saghafi
Neurology 34 years experience
NSAID's to treat: For ACUTE treatment best OTC's in my opinion with evidence based studies would be NSAIDS (ibuprofen/Motrin or Excedrin). However, I caution you that treating severe migraines with NSAID's using OTC takes knowledge and skill in order to avoid the common pitfall of overtreating. For PREVENTION- feverfew & butterbur but CAUTION! Butterbur- Severe liver damage if not properly purified and labeled.
Dr. Paul Grin
Dr. Paul Grin commented
Pain Management 37 years experience
Dr. Dariush Saghafi,your point is well taken.My example: since increased prostaglandin formation may be responsible for triggering or influencing menstrual migraine, NSAID therapy may be effective when given the week before and the week during menses. NSAIDs may also be used when traveling or during those special functions that involve increased stress such as a wedding. I manage migraine daily.
May 15, 2014
Dr. Dariush Saghafi
Neurology 34 years experience
Provided original answer
Dr. Grin- I like your thought of NSAID's used prophylactically for specialized situations & short periods. I use it in my headache practice with success.You may try adding tizanidine (1-2 mg) to Naprosyn in patients refractory to straight NSAIDs. Amerge also useful prophylactically in menstrual migraine though I always try to stay with NSAID regimens first before going to triptans.
May 15, 2014
Dr. Dariush Saghafi
Neurology 34 years experience
Provided original answer
P.S. For the nervous guy at the wedding with headaches? If it's the guy I tell him to take a beta blocker, get the garter tossed, and sneak out the back door with his bride. Nobody will know he's gone..probably won't care either....if it's the girl I recommend that she not allow the husband to do any of the wedding planning...headaches usually take care of themselves!
May 15, 2014

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Last updated May 15, 2014
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