Migraine medications divide into two groups that are managed separately: acute treatments taken to stop an attack, including analgesics, triptans and newer gepants, and preventive treatments taken regularly to reduce how often attacks occur. Taking acute treatment early in an attack matters more than which one is used, and preventives are judged over months by counting headache days.
Migraine medications divide into two groups that are managed separately: acute treatments taken to stop an attack, including analgesics, triptans and newer gepants, and preventive treatments taken regularly to reduce how often attacks occur. Taking acute treatment early in an attack matters more than which one is used, and preventives are judged over months by counting headache days.
Simple analgesics and non-steroidal anti-inflammatories help mild to moderate attacks. Triptans are migraine-specific and work on the underlying mechanism rather than masking pain; they are avoided or used cautiously where there is significant cardiovascular disease. Newer agents targeting the CGRP pathway offer an option where triptans are unsuitable or ineffective. Anti-nausea medication is often added, both for the nausea itself and because it can improve absorption. Whichever is used, taking it early in the attack matters more than which one it is.
Preventives are taken daily whether or not you have a headache, with the aim of fewer attacks rather than none. Several classes are used: certain beta blockers, some antidepressants used at neurological doses rather than for mood, and specific anti-seizure medications. Newer monoclonal antibodies targeting CGRP are given by injection at intervals. Choice depends on your other conditions, your other medications and whether pregnancy is a consideration, so what suits one person is unsuitable for another.
Preventives are judged over months by counting headache days against a baseline, not by how any single attack felt, and doses are usually increased gradually because starting high produces side effects that end the trial early. The commonest reason an effective preventive is abandoned is stopping after a fortnight at a starting dose. Separately, frequent acute medication use converts episodic migraine into a near-daily headache, so tracking days of use protects the whole plan.
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.