The best treatment for migraines is prevention. Keep a migraine log to help identify your personal migraine triggers. Granted, some of them will be unavoidable — there is not much you can do about weather changes and fluctuating hormones. But you may be surprised at how much control you can have over your pain. Change your diet to avoid the foods that trigger your migraines. Talk to your doctor about changing your medications to ones that do not have such adverse side effects. Commit to regular exercise and sleeping schedule, even on weekends and vacation, so your body can get into a normal rhythm. Learn to manage the demands of life so that stress does not overwhelm you and create even more pain.

For those who cannot prevent 100% of their migraines, there are several solutions that will not cause rebound migraines. Over-the-counter medications such as aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen sodium will work for acute, mild to moderate migraines. Prescription triptans (such as Imitrex, Maxalt, and Axert) and opioids (such as codeine and oxycodone) should relieve severe migraines and will not cause rebound headaches as long as they are used no more than twice a month.

Medications containing caffeine (such as Excedrin) are NOT recommended, as the caffeine will cause rebound migraines.

Some people have a threshold that is so low that even eliminating all of their dietary triggers will not decrease their migraines to a tolerable level. For these people, maintenance medications may be helpful. These medications, when taken on a daily basis, can increase your trigger threshold to prevent those nasty migraines. Most of these medications were not developed for migraine prevention, but are still effective. Tricyclic antidepressants, calcium channel blockers, beta blockers, and corticosteroids are commonly used. When starting a maintenance medication, it is usually best to start at a low dosage and increase as needed. These medications typically take 4-8 weeks to begin having an effect, so make sure you give yourself several months before giving up on a specific one.

Remember, prevention by eliminating triggers is the best option, so just because you are taking a maintenance medication does not mean it is ok to add known triggers back to your diet and count on the maintenance medication to work extra hard. Keep following the migraine-free diet, and you will be able to thrive on minimal amounts of medication.

Always read the labels to determine the dosage and administration schedule that is safe for you. Remember that heavy, long-term use of over-the-counter medications like NSAIDS can cause ulcers and gastrointestinal bleeding. Consult your physician before making changes to your medication regimen.