Migraine treatment has two separate halves: acute treatment to stop an attack that has started, and preventive treatment to reduce how often attacks happen. Confusing the two is the commonest reason a plan appears not to work. Acute treatment works considerably better taken early, and preventives are judged by counting headache days over months rather than by how any single attack felt.
Migraine treatment has two separate halves: acute treatment to stop an attack that has started, and preventive treatment to reduce how often attacks happen. Confusing the two is the commonest reason a plan appears not to work. Acute treatment works considerably better taken early, and preventives are judged by counting headache days over months rather than by how any single attack felt.
Acute treatment aims to abort an attack. Options range from simple analgesics and anti-inflammatories through to triptans and newer targeted agents, often with an anti-nausea medication alongside. Two principles matter more than the specific choice. Take it early, because acute treatments work considerably better in the first hour than once the attack is established. And keep track of how many days a month you use it, because frequent use converts episodic migraine into a near-daily headache, which is a genuinely common and avoidable trap.
Preventives are taken regularly whether or not you have a headache, with the aim of fewer attacks rather than none. Several classes are used, including certain blood pressure medications, antidepressants used at neurological doses, anti-seizure medications, agents targeting the CGRP pathway, and botulinum toxin for chronic migraine. They are judged by counting headache days per month against a baseline, over months rather than weeks. Judging by impression is how effective preventives get abandoned prematurely.
Regular sleep, regular meals, hydration and managing stress sound like generic advice but genuinely affect attack frequency, and irregular sleep is among the most consistently reported triggers. Identifying your own triggers through a diary is more useful than working from a general list, since trigger patterns are individual. Where medication overuse has developed, the plan involves withdrawing the overused drug alongside starting a preventive, and that is a supervised process rather than something to attempt alone.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: migraine; American Academy of Neurology; MedlinePlus, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.