Migraines can be managed with a combination of self-care strategies, over-the- counter options, and medical treatments. Here’s a concise guide to what to do if you have a migraine, plus when to seek medical help. What to do at the onset

• Find a quiet, dark place and rest. Bright light and loud sounds can worsen symptoms.
• Hydrate with water or a non-caffeinated beverage if you’re able to drink.
• Apply a cool or warm compress to your head or neck to help ease pain.
• Consider caffeine in small amounts if you typically use it and you’re early in the attack (but avoid large amounts, which can backfire).
• Try relaxation techniques such as slow breathing, gentle stretching, or progressive muscle relaxation.
• If you take preventive or acute medications, take them as directed at the first signs of a migraine. Delaying treatment can make symptoms harder to relieve.

Medications for acute Migraine (discuss with your clinician before starting)

• Over-the-counter options: NSAIDs (like ibuprofen or naproxen) or acetaminophen can help some people when taken early in an attack.
• Triptans: a common class of prescription drugs (e.g., sumatriptan, rizatriptan) that are effective for many people but not for everyone and can have side effects or contraindications (e.g., certain cardiovascular conditions). They’re most effective when taken early.
• anti-nausea meds: can help if nausea or vomiting accompanies the migraine.
• Other prescription options: newer therapies and combination approaches may be appropriate for some people, especially if headaches are frequent or particularly severe.

Non-drug strategies and lifestyle factors

• Regular sleep schedule: aim for consistent bedtimes and wake times.
• Hydration and balanced meals: avoid skipping meals and limit triggers if you can identify them.
• Regular physical activity: gentle to moderate exercise can reduce frequency for some people, but avoid intense exertion during an attack.
• Stress management and biofeedback: mindfulness, relaxation training, and cognitive-behavioral strategies can help reduce frequency and severity for some individuals.
• Trigger tracking: keep a migraine diary to identify patterns (time of day, foods, weather, sleep quality, hormones).

When to seek medical help promptly

• If your migraines are new, unusually severe, or rapidly worsening.
• If you have a sudden, severe headache like a “thunderclap” headache.
• If you experience neurological symptoms such as weakness, numbness, trouble speaking, confusion, or vision changes.
• If your current treatment isn’t helping or you’re relying on pain relief more than a couple of days per week.
• If you have risk factors for vascular disease or a history of migraine with aura and you’re unsure about using certain medications.
• If you’re pregnant, breastfeeding, or have other medical conditions or medications that could interact with migraine treatments.

Preventive options (discuss with your clinician if migraines are frequent or disabling)

• Daily preventive medications: beta-blockers, antidepressants, anti-seizure medications, or calcium channel blockers.
• CGRP-targeted therapies: newer preventive injections or infusions for some people with frequent migraines.
• Lifestyle and trigger management: consistent sleep, hydration, regular meals, stress reduction, and regular exercise.

Specialized non-drug options (discuss with a healthcare professional)

• Neuromodulation devices: noninvasive options that stimulate nerves to reduce migraine frequency or intensity.
• Additional therapies (as appropriate): physical therapy, dental evaluation if jaw tension or teeth grinding is involved, or treatment of comorbid conditions that may worsen migraines.

Notes and cautions

• Never exceed recommended doses of any medication, and avoid combining medications without medical advice due to the risk of medication-overuse headaches.
• Some treatments may be unsuitable for certain people (e.g., individuals with cardiovascular disease, pregnancy, or specific allergies). A clinician can tailor therapy to fit medical history.
• If you have concerns about drug interactions, side effects, or the impact on existing conditions, consult a healthcare professional.

If you’d like, provide more details about your symptoms (pain location, duration, triggers, frequency, current medications, pregnancy status, and any medical conditions). With that, a more personalized plan can be outlined.