Several treatments work well for migraines, ranging from over-the-counter pain relievers and cold packs for immediate relief to prescription medications and supplements that reduce how often attacks happen. What works best depends on whether you’re trying to stop a migraine in progress or prevent future ones, and most people benefit from a combination of approaches.
Over-the-Counter Pain Relievers
For mild to moderate migraines, standard painkillers are the usual first step. Ibuprofen, naproxen, and aspirin all work by reducing inflammation around the blood vessels and nerves involved in migraine pain. Taking them early, ideally within the first 30 minutes of symptoms, makes a significant difference in how well they work. Once pain has fully ramped up, OTC options become much less effective.
Combination products designed specifically for migraines pair two pain relievers with caffeine. Excedrin Migraine, for example, contains 250 mg of acetaminophen, 250 mg of aspirin, and 65 mg of caffeine per tablet. The caffeine helps your body absorb the pain relievers faster and narrows dilated blood vessels in the brain, adding its own pain-relieving effect. If you don’t have a dedicated migraine product on hand, taking ibuprofen or aspirin with a small cup of coffee can approximate the same approach.
One important caution: using any acute pain reliever more than two or three days per week can cause medication-overuse headaches, where the treatment itself starts triggering more frequent attacks. If you find yourself reaching for painkillers that often, it’s a sign you need a preventive strategy instead.
Prescription Options for Acute Attacks
When OTC medications aren’t enough, triptans are the most commonly prescribed class of drugs for stopping a migraine once it starts. They work by activating serotonin receptors, which constricts blood vessels and blocks pain signals in the brain. Most people feel meaningful relief within one to two hours. Triptans come in tablets, nasal sprays, and injections, and the faster-acting forms tend to work better for people whose migraines escalate quickly or who experience nausea early on.
A newer class of prescription medications targets a protein called CGRP, which plays a central role in migraine pain signaling. Some of these come as pills or nasal sprays for treating individual attacks and tend to cause fewer of the tightening or pressure sensations that triptans sometimes produce. They’re a useful alternative if triptans don’t work for you or if you have heart disease, which rules out triptans entirely.
Preventive Medications
If you’re experiencing four or more migraine days per month, preventive treatment can reduce how often attacks happen and how severe they are. Several older medication classes originally developed for other conditions have proven effective here, including certain blood pressure medications, antidepressants, and anti-seizure drugs. These are taken daily and typically need six to eight weeks before you’ll notice a meaningful change in migraine frequency.
The newest preventive option is a group of medications that block CGRP on an ongoing basis. Some are monthly or quarterly injections you give yourself at home, while others are daily pills or dissolving tablets. These were designed specifically for migraine prevention, so they tend to have fewer unrelated side effects than the older options. Most people see a noticeable drop in monthly migraine days within the first month or two.
Supplements Worth Trying
Three supplements have enough clinical evidence behind them that neurologists regularly recommend them. Riboflavin (vitamin B2) at 400 mg daily has been shown to reduce migraine frequency, likely by improving how brain cells produce energy. CoQ10 at 300 mg daily also reduces migraine frequency in adults, working through a similar energy-metabolism pathway. And magnesium, which many migraine sufferers are low in, helps regulate nerve signaling and blood vessel tone. Magnesium oxide or citrate are the forms most commonly used for migraine prevention.
These supplements are slow-acting. Most studies show benefits emerging after two to three months of consistent daily use. They’re worth considering as an add-on to other treatments or as a first-line approach if you prefer to start with something lower-risk before moving to prescription medication.
Cold Therapy During an Attack
Applying a cold pack to your forehead, temples, or the back of your neck is one of the simplest and most underrated tools for migraine relief. In a study of 60 people with episodic migraines, 63% started with severe pain and 37% with moderate pain. After cold pack application, 75% reported only mild pain and 15% had no pain at all. Cold narrows blood vessels and dulls nerve activity in the area, which can take the edge off while you wait for medication to kick in. A bag of frozen peas wrapped in a thin towel works fine. Apply it for 15 to 20 minutes at a time.
Biofeedback and Relaxation Training
Biofeedback teaches you to consciously control physical responses that are normally automatic, like muscle tension, heart rate, and skin temperature. During sessions, sensors track these signals in real time while a therapist guides you through relaxation techniques. Over time, you learn to recognize the early physical signs of a migraine building and interrupt it before it fully develops. According to the American Migraine Foundation, biofeedback and relaxation training can produce a 45% to 60% reduction in headache frequency and severity.
This approach is especially useful for people whose migraines are closely tied to stress, those who want to reduce their medication use, and pregnant women who need non-drug options. Most people need 8 to 12 sessions to learn the techniques well enough to use them independently.
Dietary Triggers
Between 18% and 30% of migraine sufferers in clinic-based studies identify specific foods or drinks as triggers. The most common culprits include aged cheeses, cured meats, red wine, chocolate, and fermented foods. These contain naturally occurring compounds like tyramine, histamine, and nitrites that can provoke attacks in susceptible people. Alcohol, particularly red wine, is one of the most frequently reported triggers.
The tricky part is that food triggers vary enormously from person to person, and a food that causes a migraine one day might not the next, because triggers often stack. You might tolerate aged cheese fine on a well-rested, low-stress day but not when you’re also sleep-deprived and dehydrated. Keeping a headache diary that tracks food, sleep, stress, weather, and menstrual cycle (if relevant) for two to three months is the most reliable way to identify your personal patterns. Eliminating entire food groups without evidence of a connection isn’t necessary and often isn’t helpful.
Sleep, Hydration, and Routine
Migraine brains dislike change. Irregular sleep is one of the most consistent and powerful migraine triggers, and it works in both directions: too little sleep and too much sleep can both provoke attacks. Going to bed and waking up at the same time every day, even on weekends, is one of the highest-impact lifestyle changes you can make. Skipping meals is another common trigger, particularly when combined with dehydration. Keeping a water bottle handy and eating at regular intervals addresses two triggers at once with minimal effort.
Exercise helps too, though the relationship is nuanced. Regular moderate aerobic activity, like 30 minutes of brisk walking or cycling several times a week, reduces migraine frequency over time. But sudden intense exertion can trigger an attack, especially if you’re not well-hydrated or warmed up. Starting gradually and building up intensity over weeks gives your brain time to adjust.