Migraine medications are divided up by class of drug and the purpose of the medication.

For those have any migraine and frequent headaches (whether these are migraines or not), migraine prevention agents are warranted. The best medications for migraine prevention include Elavil® (amitriptyline), Inderal® (propranolol), Depakote® (valproic acid), and Topamax® (topirmate). A less proven medication but possibly just as effective is coenzyme Q10. Migraine prevention agents found to be useful but less effective include verapamil, prozac, botulinum toxin, feverfew, and neurontin. Sometimes to break an acute long term migraine prednisone or other steroids will be used. Inpatient therapy is sometimes required for patients who are also using an excessive amount of acute medications. In this case, dihydroergotamine (DHE-45®) is commonly given as well.

When the headaches are relatively infrequent, then the acute migraine treatments include the triptans and migranal nose spray. Less effective medications include over the counter excedrin migraine and aleve.

When headaches are frequent, it is important to avoid rebound headaches. The two medications most agree that do not cause rebound headache are dihydroergotamine (DHE-45® or migranal) and and Bextra® (valdecoxib).