Treatment usually first involves avoiding factors known to cause a migraine attack, such as foods, environmental triggers such as perfume, and medications such as birth control pills. Over-the-counter, anti-inflammatory medications (such as aspirin, ibuprofen, etc.) may reduce the severity of an acute attack. Drugs that constrict the blood vessels, including caffeine and ergotamines, are sometimes used. Also, certain prescription medications that deal directly with the presumed chemical imbalances of migraine are available (including Imitrex®, Amerge®, Maxalt®, and Zomig®).
If migraine attacks are severe or frequent enough, medication may be required on a regular basis to prevent migraine. The four most commonly used medication groups are tricyclics, beta-blockers, calcium channel blockers, and some anti-seizure medications.
Botox (botulinum toxin) injections also are sometimes used to treat chronic migraine, with multiple injections around the head and neck given over a period of weeks to help dull future headache symptoms.
Your ophthalmologist (Eye M.D.) may provide migraine treatment, or may refer you to a neurologist or another specialist for further tests and evaluation.