Therapy for a migraine


In the meantime there are different drug groups for the therapy of migraine available.

The drugs used are essentially dependent on the severity of the Migraine attack.

One differentiates three degrees of severity:

  1. mild seizures
  2. moderate seizures
  3. severe seizures

Against nausea and Vomit come active ingredients like Metoclopramide (Paspertin) or Domperidone (Motilium) for use. They lead to a reduction in nausea and activate the gastric and intestinal activity, which comes to a standstill during migraines. This creates the basis for taking additional medication, such as pain relievers.

In principle, classic pain relievers such as acetylsalicylic acid (aspirin) or Paracetamol, but also non-steroidal anti-inflammatory drugs (NSAIDs) how Ibuprofen or Dicolfenac (Voltaren) or Metamizole (Novalgin) used. Sometimes stronger pain relievers like Valoron be helpful.

Ergotamine preparations (ergot derivatives = alkaloids) are used to regulate the vessel width. Unfortunately, ergotamines have some side effects. Their vasoconstricting effect can lead to circulatory disorders elsewhere. They must therefore not be used in the case of known circulatory disorders of the coronary arteries. Regular intake of ergotamines can lead to a withdrawal headache due to medication if no more intake of ergotamines, which creates a vicious cycle. Ergotamines should therefore not be taken more than 10-12 times a month.
They only work at the beginning of the attack and must therefore be taken in the early phase.

The group of triptans has been used successfully in migraine therapy for several years. They are not actually pain relievers and therefore only help with migraine headaches. Pharmacologically, they act as serotinin agonists. This means that they stimulate - by their related appearance like serotonin - serotonin receptors (5-HT 1B / 1D - receptors), which leads to a reduction in headache, nausea and vomiting. Due to its temporary effectiveness, symptoms can reappear after a few hours, which can be reduced by taking the medicine again. Several manufacturers now offer different triptans such as almotriptan, naratriptan, sumatriptan or eletriptan.

Further information on the subject can be found here: Triptans

Behavioral therapy, which can be learned from specially trained psychotherapists and psychiatrists, can also influence migraines. Special relaxation techniques have been shown to be effective.

Biofeedback - not particularly common - but helps during an acute attack. In special laboratories, one can learn to “make visible” the vessel width of the meninges, to consciously influence the width of the vessels, whereby the migraine attack is to be “controlled”.

Note: Progressive muscle relaxation

In collaboration with our chronic pain therapy team, we have developed a special program aimed at people who suffer from chronic back pain, headaches or migraines. Progressive muscle relaxation has proven to be particularly helpful in these clinical pictures.
For more information, see Progressive Muscle Relaxation.


So-called beta blockers such as metoprolol and propranolol and calcium antagonists such as flunarizine are used for migraine prophylaxis, i.e. drugs to prevent migraine attacks or to reduce the frequency of migraines. These drugs are usually taken daily for prophylaxis. Since they belong to the group of high blood pressure drugs, they have an effect or side effect that lowers blood pressure.

Indications for migraine prophylaxis can be:

  • > 3 seizures per month
  • multiple status migraines (see above)
  • strong subjective impairment of quality of life
  • neurological disorders caused by the migraines (see above)

It has not been scientifically proven, but has been experienced several times under positive subjective observation, acupuncture is particularly effective in the acute phase, but also as prophylaxis after several sessions. The right choice of acupuncture points during the acute and prophylactic phase is important here.

Furthermore, endurance sports such as jogging and cycling have shown to be beneficial for development in studies. Jogging with a medium pulse rate in particular should have a positive effect on the symptom-free intervals.

In general, it is important to know possible triggers for a migraine attack in order to be able to counteract them in good time. Keeping a headache diary is very suitable for this. In it u. a. Time, severity, duration and the accompanying circumstances of the migraine headache recorded.

Read on below: Headache diary

Which doctor treats migraines?

Who should initiate migraine therapy?
Since migraines are a neurological disease, the neurologist is the right contact for you. Alternatively, pain therapists can treat migraines.