5 Signs Your Migraine Treatment Isn’t Working

Medically reviewed by Deborah Weatherspoon, Ph.D, MSN, RN, CRNA on May 3, 2016Written by Jennifer Berry on May 3, 2016
migraine treatment efficacy

When you get a migraine, all you want is relief. Although different medications are available, no single treatment works for everyone. Your doctor will work with you to create a treatment plan based on your health history, your symptoms, and how often your migraines occur. Treatment plans often include a combination of medications and lifestyle changes.

Even if you have a solid plan in place, you need to keep track of how well it’s working. If you notice any of the following five signs, your plan may not be the right fit for you. These five signs may mean it’s time to talk to your doctor about a different plan for your migraines.

1. You take rescue medications regularly.

To evaluate how well your migraine plan is working, you need to know the different parts of your plan and what they’re supposed to do. Your plan may include preventive medications, abortive medications, and rescue medications.

  • Preventive medications: These are designed to stop migraines before they start. Preventive medications must be taken daily to work properly. The right preventive medication should cut down on the number of migraines you experience.
  • Abortive medications: You only take abortive medications when you feel a migraine coming on, hopefully as early as possible. It’s a good idea to keep these with you at all times so you can take them quickly, before a full-blown migraine occurs. They’re designed to relieve the symptoms of your migraine.
  • Rescue medications: These medications are taken only if your preventive or abortive medications fail to give you relief. They may be prescription or over-the-counter.

Although many people have rescue medications as a backup, they shouldn’t be taken regularly. If you need rescue medications on a regular basis, this likely means that your preventive or abortive medications should be changed.

Also, relying on rescue medications could be dangerous and cause unwanted side effects. This can also lead to rebound headaches, known as medication overuse headaches (MOHs). According to the National Headache Foundation, taking even common pain relievers for more than 15 days per month puts you at risk of getting MOHs. Prescription medications such as triptans, opioids, ergots, and barbiturates shouldn’t be used more than 10 days per month.

2. You’re still having frequent migraines.

If you’ve been taking a preventive treatment, you should have fewer migraines. Over time, this should reduce your need for abortive medications or rescue medications.

You may need a different preventive medication if:

  • You’re taking your preventive treatment as prescribed and you’re still getting regular migraines.
  • You haven’t seen a reduction in the number of migraines after three months.
  • You’re taking abortive medications more than twice a week.

A stronger dose may also help if you’re relying too heavily on abortive medications.

3. You have unwanted side effects.

Like any medication, migraine treatments can cause side effects. They may range from nausea to constipation to dizziness. Finding the right medication and the right dose will minimize these effects so you can take the medication when you need it.

For any treatment to work effectively, you need to take the proper dose at the right time. If you’re hesitating to take your medication or skipping it because side effects are bothering you, the treatment plan isn’t working for you. Often, a different dose or different medication can help you avoid these issues.

4. You aren’t getting relief fast enough.

When a migraine hits, you want relief as quickly as possible. The right abortive medication should begin to work quickly, especially if you take it early.

The American Headache Society says effective migraine treatment should provide relief within two to four hours. You should be back to normal activity within three to four hours. If you’ve taken your medications and your migraine doesn’t greatly diminish within this timeframe, the medications may not be the best fit for you. When you don’t get relief from your migraine, you may resort to using other options such as rescue medications. You also risk taking too much of one kind of medication to reduce the pain.

5. Your migraines are still interfering with your life.

A migraine has a way of bringing your life to a screeching halt. Are you still missing work regularly, skipping social activities, or unable to carry on with daily life because of your migraines?

Finding the right treatment plan means you can prevent and treat your migraines quickly and efficiently. This allows you to continue your day with minimal disruptions. Although no migraine plan is guaranteed to prevent all of your migraines all the time, you should see a significant improvement in their frequency as well as the severity of your symptoms. If not, talk with your doctor about your plan and discuss other options.

Evaluating your plan

Although migraine treatments have improved over the last several decades, developing the right plan for you may require some trial and error. Your doctor will choose medications that are likely to work for you with minimal side effects. The first attempt isn’t always the perfect solution, though. For this reason, open and honest communication with your doctor is a must when you’re trying to find an effective treatment plan.

Your treatment may also include lifestyle changes, such as:

  • identifying and avoiding your triggers
  • diet changes
  • relaxation exercises

For maximum effectiveness, be sure you understand and follow all the parts of your plan, including lifestyle changes.

Don’t get discouraged if you don’t get relief right away. It may take two to three months or longer to determine whether the plan is working for you. Ask your doctor when you should expect to see improvement so you know when to evaluate your plan.

Keeping track

Tracking how well your migraine treatment plan works may be easier if you keep a headache diary. This can be an effective communication tool for you and your doctor when evaluating your current plan and looking into different options. Your headache diary should include the following information:

  • date and time of your migraines
  • any migraine triggers you may have encountered
  • the severity of the pain
  • medications you took for relief
  • how long the pain lasted after taking the medication
  • what kind of relief you got from the medication

You shouldn’t modify or change medications without discussing your plan with your doctor. But don’t be afraid to talk to them about other options if your treatment plan isn’t working for you.

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