Most people experience headaches from time to time. There are a number of types of headaches, and most only cause mild or temporary pain. But some types of headaches — for instance, migraine headaches — can interfere with your daily activities.
Abortive therapy is a type of treatment for migraine and other common types of headaches. It’s intended to stop headaches after they’ve begun. Also known as acute migraine therapy, the treatment targets symptoms like head pain, nausea, and vomiting.
Keep reading to learn more about abortive therapy, including effectiveness, types, cost, and potential side effects.
Most forms of abortive therapy involve taking over-the-counter or prescription medication when you start to notice symptoms.
Effectiveness varies significantly according to the medication you take and the severity of your headache. Most mild headaches can be relieved with over-the-counter (OTC) pain relievers, such as:
What the research says
A 2020 review in Current Pain and Headache Reportsfound that medications like acetaminophen, ibuprofen, naproxen, and aspirin are often effective for mild to moderate migraine. A combination drug containing one or more painkillers may also be effective at relieving milder migraine.
For severe pain, triptans may be prescribed as abortive therapy. Triptans are a class of medication that block certain pain signals in the brain.
Triptans can vary in efficacy. A 2014 review in the Cochrane Database of Systematic Reviewsconcluded that a 100-milligram (mg) dose of sumatriptan, a commonly prescribed triptan, was effective at eliminating headache pain and related symptoms in about 59 percent of people in the studies reviewed.
Other drugs vary in effectiveness but may also be helpful in cases where triptans do not work for acute headache pain, such as:
- ergot alkaloids
- CGRP antagonists
The 2021 American Headache Society Consensus Statement reports that abortive therapies, including those listed above, are more effective when taken within 15 minutes of headache onset and when pain is mild.
There are many types of abortive therapy available for migraine and other headaches. The following are some of the most common.
Over-the-counter (OTC) painkillers
OTC painkillers are the first choice of treatment for many types of headaches, including:
- migraine headaches
- tension headaches
OTC painkillers include acetaminophen (Tylenol) as well as the following nonsteroidal anti-inflammatory drugs (NSAIDs):
Indomethacin is typically the first choice for treating hemicrania continua. The use of this medication can help diagnose and prevent the condition.
Combination painkillers typically include one or more of the drugs listed above, such as aspirin and acetaminophen.
Triptans are used to treat moderate to severe recurring migraine and cluster headaches.
Some common triptans include:
Injectable triptans are often used to treat cluster headaches because of how rapidly they can help treat the severity of cluster headache symptoms.
Ergot alkaloids, including dihydroergotamine mesylate (DHE) and ergotamine, are typically prescribed for severe migraine in cases where triptans are ineffective or cause too many side effects.
Lasmiditan is a recently-approved abortive therapy for migraines.
Part of a new class of drugs called ditans, lasmiditan works like a triptan but causes fewer side effects for people who have cardiovascular risk factors.
Calcitonin gene-related peptide receptor antagonists (CGRPs) are another newer option when it comes to abortive migraine treatment.
These drugs, which include ubrogepant and rimegepant, work by stopping a protein involved in pain signaling.
Abortive therapy can range in price depending on the drug, the dose, and the route of administration. The overall cost will also depend on how frequently you experience headaches.
OTC painkillers are fairly affordable at under $20 for a bottle of pills and may be available as a prescription from your doctor at a reduced cost. Generic versions are also less costly than brand-name versions. But unless you have a prescription for your doctor, you won’t be able to receive reimbursement from your health insurance.
Most or all of the costs associated with abortive therapy medications are typically covered by insurance. According to Consumer Reports, prescription abortive therapies like triptans can range in price from $12 to $46 per pill without insurance coverage.
A doctor can explain in detail how to take your abortive therapy medications.
Some types of medication are taken orally, while others are taken via a nasal spray or injection. You should take your medication as soon as you start to feel migraine symptoms — the earlier the better.
When headaches are frequent, abortive therapies may be used in combination with preventive therapy. If you find yourself using abortive therapy more than 2 to 3 times per week, see a doctor to discuss preventive treatment.
Abortive therapy can cause side effects that depend on the drug you take and the dose.
Some common side effects for each type of abortive therapy are listed in the chart below.
|Drug||Potential side effects|
|OTC painkillers||liver damage, indigestion, stomach aches, ulcers, gastrointestinal bleeding|
|triptans||nausea, dizziness, chest pain, tingling, neck pain, cardiovascular complications|
|ergot alkaloids||nausea, vomiting, muscle aches, weakness, numbness, slow or fast heartbeat, itching|
|lasmiditan||dizziness, lethargy, sedation, tingling|
|CGRP antagonists||nausea, headaches, dry mouth, tingling, vision problems|
Talk to a doctor if you are concerned about possible abortive therapy side effects, especially if you have not previously tried one or more of these treatments.
Abortive therapy is used to stop headaches such as migraines after they’ve started.
Common abortive therapy drugs include OTC painkillers and triptans. When these options do not work, ergot alkaloids, lasmiditan, and CGRP antagonists may be prescribed.
Talk to a doctor about your headache symptoms to learn whether one of these treatments might be right for you.