Headache Treatment: Pharmacological Therapies
Once diagnosed, educating yourself on the type of headache you have and appropriate treatment for it can help you effectively manage it. For many headaches sufferers, some combination of stress management therapy and medication is often an effective way to manage their disorder. Headache medications fall into three categories: abortive, preventive, and rescue.

Because people react differently to various medications and therapies, you and your physician will need to find the right combination to help you prevent and effectively manage emerging headaches.

The good news is that headache research and treatment are evolving specialties. New and increasingly successful therapies are emerging every day.

Abortive Medications
Abortive (also called acute or symptomatic) medications are drugs used to halt or lessen the severity of an attack. During an attack, blood vessels in the brain widen or dilate. Abortive medications work by narrowing or constricting these blood vessels. They are used to stop severe headaches, such as migraines or cluster headaches, from getting worse as symptoms emerge.

Abortive headache medications include:

• Triptans (such as Imitrex or Amerge) Triptans are agonists that affect the 1B and 1D serotonin receptors located in neurons and cerebral vessels.
• Ergotamines (such as Ercaf, Cafergot, or Migranal) Ergotamines are an appropriate choice for patients who have moderate to severe migraine that does not respond to analgesics or who experience significant side effects from other migraine medications.
• Simple analgesics (such as aspirin or acetaminophen)
• Combined Analgesics (analgesics formulated with caffeine or other adjuvants)
• Opioid analgesics (such as codeine plus aspirin or acetaminophen)

Preventive Medications
Most headache prevention medicines were developed to treat other conditions, such as high blood pressure, depression or seizures, and only later found to be effective for headache. Preventive therapy (also known as prophylactic therapy) is a regimen where specific types of medications are taken every day (whether there is a headache present or not) to correct a biochemical imbalance.

Preventive headache medications include:

• Non-steroidal Anti-inflammatory Drugs (NSAIDs). (such as ibuprofen or naproxen sodium) Both over-the-counter and prescription-strength NSAIDs are sometimes used successfully as a daily preventive treatment.
• Antiepileptic drugs (such as divalproex, valproate and topiramate) Originally developed as a treatment for epilepsy and other seizure disorders, these drugs have been approved for treatment of bipolar disorder (manic depression) and migraine.
• Beta Blockers. (such as propranolol or inderal) Originally developed to treat high blood pressure, beta blockers have since been approved by the FDA as a preventive treatment for migraine.
• Calcium channel blockers (such as verapamil, nifedipine, and nimodipine)
• Antidepressants (such as amitriptyline, nortriptyline, doxepin, and protriptyline) Tricyclics and certain other antidepressant medications appear to be beneficial for migraine prevention.
• Antiemetics (such as metoclopramide, chlorpromazine, and prochlorperazine) Agents used to treat migraine and the emesis (vomiting) associated with acute attacks.

Rescue Medications
Rescue medications are generally used only after abortive medication strategies have failed. Most rescue medications can be taken at home, but more aggressive therapies, requiring intramuscular or intravenous injections, are administered in the emergency room or in a physician's office. Medications typically used as rescue therapy include:

• Opiates
• Barbiturate hypnotics
• Steroids
• Phenothiazines

Many rescue medications cause drowsiness as a side effect. For some sufferers, this may induce sleep that can be helpful for seeking pain relief; for others, this may inhibit their ability to continue in their daily routine.