Author: Editorial Team

Sinuses have been documented, studied, and pondered since at least the ancient Egyptians’ time. They have a vast array of purposes and benefits for our well-being, including prepping air for inhalation, protecting our brains and immune systems, and shaping our voices. While this structure is incredible and complex, it has limitations. This article explores sinus headaches, their causes, symptoms, and treatment/management options.

What is a Sinus Headache?

Definition and Key Features of Sinus Headache

Generally, sinus headaches are caused by inflammation or congestion in the sinuses (i.e., air-filled spaces around the nose, eyes, and forehead). This can occur during a sinus infection (e.g., sinusitis) or severe allergies. Key symptoms include pain and pressure in the face or forehead (often worse with movement), nasal congestion, and sometimes a runny nose or reduced sense of smell.

However, it’s important to note many headaches people think are sinus-related are actually migraine or tension headaches. These types of headaches can mimic sinus pain but aren’t caused by sinus inflammation. In fact, “sinus headache” isn’t an official medical diagnosis. Sinus headaches due to sinus inflammation are relatively rare and usually appear with signs of infection, such as fever, thick nasal discharge, or facial tenderness.¹

Common Misconceptions About Sinus Headache

Numerous common myths exist about sinus headaches. Whether from symptom overlap, incorrect patient observations, or even public perception and advertising, these misconceptions can negatively impact identifying, diagnosing and, more importantly, treating and managing sinus headache symptoms.

What Causes Sinus Headache?

It can be tricky to determine the root cause of head pain around the sinuses. This was illustrated during the 2021 Migraine World Summit, with Dr. Peter Goadsby discussing the specific nerve pathways that supply pain sensation to the head and face, the ways they impact how and where pain is perceived, and the resulting complex journey to determining cause and treatment.³

However, for sinus-centered headaches, originating from the sinuses, there are some common culprits.

Sinus Infections and Rhinosinusitis Explained

Both sinus infections and rhinosinusitis refer to swelling or inflammation of the sinuses. Although these terms are often used interchangeably, rhinosinusitis is the correct medical term for inflammation of both the nasal passages (rhinitis) and sinuses (sinusitis).⁴ 

To recap, sinuses are air-filled cavities located in the skull around the nose, eyes, and forehead, and they produce mucus to trap dust and pathogens. Therefore, sinusitis (aka a sinus infection) happens when sinuses become inflamed, swollen, or infected. There are varying types of sinus infections (i.e., a spectrum of acute to chronic, and allergic vs. non-allergic). 

As mentioned above, rhinosinusitis is broader and describes combined inflammation of the nasal passages and sinuses. Causes, symptoms, and classifications are the same as those for sinus infections but focus on both areas. Regardless, both stem from instigators like viruses, bacteria, fungi, allergies/allergens, or anatomy. Read on for more on these last two causes.

Allergens & Environmental Triggers

Since sinus head pain is often linked to inflammation or congestion in the sinuses, allergies and/or environmental factors can trigger or exacerbate these headaches.

Allergies (e.g., allergic rhinitis, more commonly known as hay fever) can cause inflammation in nasal passages and sinuses, leading to a flood of symptoms and resulting in sinus pain. Breaking this down step by step, here is what happens:

1. An allergen (e.g., pollen, dust, pet dander, mold, etc.) triggers the body to create and release histamines. 
2. Histamine effects are what we notice/experience as inflamed, swollen, and mucus-filled nasal passages and sinuses.
3. Swelling blocks drainage and traps mucus in the sinuses, and causes pressure/pain (i.e., sinus headache).
4. Continued exposure to allergens leads to persistent allergies and sinus headaches.

Environmental conditions, on the other hand, can exacerbate sinus inflammation or congestion, contributing to sinus pain. These elements include air quality, weather changes, extreme temperatures, and problematic workplace conditions (e.g., exposure to dust, fumes, or chemicals).

Structural Issues

There are instances where external influences do not cause sinus headaches, nor does the bodily reaction to said factors cause them. Sometimes, our body composition (e.g., ​​anatomical abnormalities blocking normal airflow and drainage) can be the reason for sinus discomfort.⁴

Deviated Septum and Nasal Polyps

A deviated septum occurs when the nasal wall (the membrane separating our nostrils) is displaced to one side, partly or entirely blocking a nasal passage. As has been said before, blocked sinuses impact drainage, often creating pressure and, as a result, pain that mimics or contributes to sinus headaches.

Nasal polyps are growths (non-cancerous) that develop in the lining of nasal passages or sinuses, often due to chronic inflammation (e.g., from allergies or asthma). Like deviated septums, polyps cut off the flow, resulting in pressure, buildup, and sinus pain.

Symptoms of Sinus Headache

It is worth repeating that these elusive headache types are typically caused by inflammation or blockage in the sinuses, which leads to pressure and pain. Before diving into symptom specifics, exploring how a sinus headache differs from similar headache types is valuable.

Distinguishing Sinus Headache From Other Headache Types

Sinus headaches, migraine, and tension headaches can have overlapping symptoms, making it easy to confuse the three. However, they differ in causes, triggers, and accompanying symptoms. 

During the 2023 Migraine World Summit, Dr. Mark Mehle explains just how often sinus headaches can be mistaken for other types of headaches. He also offers advice on determining the cause. Dr. Mehle says, “The timing, and the secondary symptoms are exactly what you want to hang your hat on.” After all, the similarities are so striking.

He reiterates, “I think the pain is identical. It really is. It’s just stimulation of the trigeminal nerve — whether it’s stimulated in the sinuses by pus and infection or stimulated centrally by the brain-triggering pain along the trigeminal nerve, is kind of irrelevant. It feels the same to the patient. So, it’s very hard to sort out. And I think that the timing is the key factor, plus those secondary effects.”⁵

Here’s a brief comparison to help distinguish the differences among these similar headache scenarios¹:

Facial Pain

Facial pain is a prominent symptom of sinus headaches, which, as stated before, are often caused by inflammation or pressure in the sinus cavities and are directly linked to various factors. Your physician may ask the following questions to help determine a diagnosis.

• Where is the pain (i.e., eyes, forehead, and/or cheeks)? 
• What is the pain like (e.g., sensation type, facial pressure/fullness, and side of the sinuses)?
• What triggers the pain (e.g., time of day, movement, or weather)?
• What other symptoms are there?

Why is the pain happening (i.e., sinus infection, allergies, and structural issues mentioned earlier)?⁸

Nasal Symptoms

Another telltale sign of sinus headache is nasal symptoms, which are again due to blockage of the paranasal sinuses. These accompanying symptoms to head pain are often hard to ignore.

At the 2022 Migraine World Summit, Dr. Christopher Gottschalk emphasizes the extent to which the complexities of pain and associated symptoms in such a confined space causes confusion for the individual, as well as for healthcare professionals. For example, he states, “The fact that you’re talking about somebody who gets pain on one side with a red eye and a runny nose and stuffiness, and sometimes fullness in their ear, etc., it is as likely as not to be thought of as some kind of sinus problem. We know that getting diagnosed with sinus headache in migraine is common, and as far as we can tell, there really is no such thing as sinus headache. But in cluster even more so, because there are such clear features of something to do with the sinuses.”⁷

When to Worry: Risk Factors for Serious Sinus Headache

Symptoms associated with sinus head pain are often benign, but in some cases, they may signal more serious conditions. Red flags, as explained in the table below, are important to pay attention to with sinus headaches, as in some rare cases, they can be signs of:

• Serious infections
• Vision issues
• Structural problems
• A weakened immune system
• Spreading to other areas
• Underlying health difficulties
• Sudden emergencies 

Timely medical help is vital to prevent long-term damage, avoid life-threatening situations, and ensure effective treatment. Here is a general breakdown of risk factors and warning signs for sinus headaches.²

Any of the symptoms above are sufficient reasons to seek professional help. If sinus headaches are frequent or affecting your quality of life, schedule a visit with your doctor to discuss what’s going on and what to do about it.

Sinus Headache Diagnostics & Treatment

History, Examination, & Diagnostic Tools

Diagnosing the cause of a sinus headache, like other ailments, begins with a medical history and physical exam. Doctors will ask about symptoms, including duration, triggers, and associated factors. During an exam doctors may check for facial tenderness, examine nasal passages using specific tools, and assess for other conditions (e.g., migraine headaches and tension headaches) that mimic sinus headaches’ symptoms.¹¹

If the above assessment strategies are inconclusive, other diagnostic tools are sometimes used, including:

• X-rays
• CT scans
• Allergy tests
• Nasal endoscopy (a tube with a camera that goes into the nasal passages) 

As mentioned earlier, since other types of headaches originate in a similar area as headaches caused by sinusitis, individuals, including health professionals, can find it challenging to know what is happening. Hence, further tests may be warranted. 

Dr. Robert Cowan dives into this concept at the 2020 Migraine World Summit:⁹

Treatment Options

Once it’s confirmed that a person has a sinus headache, the next step is to find the appropriate treatment to relieve symptoms and address underlying causes.¹⁰

Home Remedies and Natural Solutions

Over-the-Counter (OTC) Medications for Sinus Relief

There are three main OTC medications for sinus headaches available without a prescription. They are:

• Antihistamines
  • For sinus headaches triggered by allergies
  • Reduce inflammation and mucus production
• Decongestants
  • Available as sprays or tablets
  • Relieve nasal congestion and reduce sinus pressure
• Nasal corticosteroids
  • Minimize inflammation and improve sinus drainage

Prescription Medications for Sinus Relief

Antibiotics and higher-potency decongestants require a medical professional’s visit and prescription. Antibiotics are only used to treat bacterial sinus infections, not viral or allergy-related sinus issues. Strong decongestants can also tackle severe or chronic cases of inflamed sinuses.¹¹

Prevention

Preventing sinus headaches requires a proactive and holistic approach. By managing allergies, maintaining healthy sinuses, and making key lifestyle adjustments, the frequency and severity of sinus headaches can be reduced.¹²

Managing Allergies and Avoiding Triggers

Since allergies are a common cause of sinus inflammation and head pain, identifying and avoiding allergens can play a huge role in prevention. This can include identifying and, if possible, avoiding culprit allergens (e.g., pollen, dust, or dander). Using things like air purifiers, washing your bedding often, and vacuuming regularly can also minimize allergens in your frequently occupied spaces.

Keeping Your Sinuses Healthy

Healthy sinuses involve keeping nasal passages clear and reducing irritants contributing to inflammation. Small and consistent habits can make a big difference, including:

• Regular nasal irrigation with saline
• Avoiding smoking or exposure to secondhand smoke
• Staying hydrated and aiming for a diet rich in anti-inflammatory foods

Lifestyle Adjustments for Long-term Relief

Long-term relief from sinus headaches often requires changes to daily habits. Adjustments to your routine can prevent future episodes and improve your overall quality of life. Managing stress through relaxation techniques (e.g., yoga, meditation, or deep breathing) can reduce inflammation and support immune function, lowering the risk of sinus infections. Regular exercise improves circulation, which helps clear nasal passages and boost immunity. Avoiding sudden or significant temperature changes prevents nasal passage constriction, reducing mucus buildup and the likelihood of congestion-related headaches.¹⁰

Living With Chronic Sinus Headache

Chronic sinus headaches can significantly impact day-to-day life, but there are approaches and resources to help manage symptoms. For example, managing chronic sinus disease involves recognizing symptoms early and reducing stress to minimize flare-ups. Consistent self care can make a big difference.

It is also important to mention that living with ongoing sinus headaches can leave people feeling very alone, but that need not be the case. Support groups and reliable resources can provide valuable information and emotional support. One option is to join support groups (local or online) to connect with others dealing with chronic sinus headaches or refer to trusted resources (e.g., medical organizations or clinics) for up-to-date treatment options and advice.⁸

Conclusion

Sinus headaches can be complicated, but understanding their causes and treatments can empower you to manage them well. Prevention, early diagnosis, and timely treatment are key. If symptoms continue or worsen, seek the right help to find the solutions right for you, and get control over your health again.

Resources and References

Further Reading

• Mayo Clinic. (n.d.). Sinus headaches: Symptoms & causes. Retrieved January 27, 2025, from https://www.mayoclinic.org/diseases-conditions/sinus-headaches/symptoms-causes/syc-20377580 
• WebMD. (n.d.). Sinus headaches: Causes, symptoms, and treatment. Retrieved January 27, 2025, from https://www.webmd.com/migraines-headaches/sinus-headaches 
• Cleveland Clinic. (n.d.). Sinus headaches. Retrieved January 27, 2025, from https://my.clevelandclinic.org/health/diseases/9641-sinus-headaches 
• Patel, Z. M., Setzen, M., & Poetker, D. M. (2009). Sinus headache: Avoiding over- and mis-diagnosis. American Journal of Rhinology & Allergy, 23(4), 325–329. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19344297/
• Schreiber, C. P., Hutchinson, S., & Dodick, D. W. (2005). Sinus headache: A neurology, otolaryngology, allergy perspective. Cephalalgia, 25(1), 43–49. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16007896/

Supports

• National Headache Foundation: This organization offers educational materials, patient assistance programs, and community support for those experiencing various headache disorders, including sinus headaches. Its website provides access to resources such as patient stories, podcasts, and tools for managing headache symptoms. 
• American Migraine Foundation: This foundation offers resources to help people connect with others who understand the challenges of living with headaches, including sinus-related headaches. 
• Miles for Migraine – Migraine Support and Community Groups: Brings together individuals to connect, share, and discover resources related to migraine and headache disorders. These groups offer supportive discussions and helpful materials to better navigate life with head pain, including sinus headaches.
• Mayo Clinic Connect: Online community where patients can share experiences and find support related to sinus infections and associated headaches, offering a platform to connect with others facing similar health issues.
• Asthma and Allergy Foundation of America (AAFA): Provides support for individuals with asthma and allergies, which can be related to sinus issues. It offers online communities and local support groups for patients seeking assistance and connection.
  

An Introduction to Triptans

Triptans are a class of drugs specifically designed for the acute episodic treatment of migraine attacks. The first triptan, sumatriptan (Imitrex), was available for the abortive treatment of migraine in 1992, making triptans a well-established migraine treatment option today. Triptans are often one of the first drugs prescribed to individuals living with migraine. Today, there are seven different types of triptans that have emerged since the early 1990s.¹³

In an interview with Dr. Messoud Ashina, professor of neurology at the University of Copenhagen in Denmark, Paula Dumas of the Migraine World Summit asks about the 10-step treatment plan for migraine.²

Types of Triptans

Triptans are often where physicians’ playbooks start, as today they remain a first-line acute treatment for migraine. There are seven different types of Triptans: ^5,13

1. almotriptan (e.g., Axert)
2. eletriptan (e.g., Relpax)
3. naratriptan (e.g., Amerge)
4. rizatriptan (e.g., Maxalt, Maxalt Mlt)
5. sumatriptan (e.g., Imitrex, Onzetra Xsail, Tosymra, Zembrace, Symtouch, Sumavel DosePro)
6. frovatriptan (e.g., Frova)
7. zolmitriptan (e.g., Zomig, Zomig ZMT)

How Triptans Work

Triptans are serotonin reuptake inhibitors, also known as serotonin agonists and vasoconstrictors. This means triptans bind to serotonin receptor sites to both stabilize serotonin levels and inhibit the release of calcitonin gene-related peptide (CGRP). At the same time, triptans cause blood vessels to constrict (vasoconstriction).⁶ Triptans bind specifically to serotonin sites 5HT1B and 5HT1D, which changes the way pain is communicated by the cranial nerves to the brain.¹³ Through vasoconstriction, there is less blood flow to the brain, which is believed to reduce pressure placed on the blood vessels. It lessens the inflammatory pain experienced during a migraine attack.⁴

Dr. Deborah Friedman, neurologist, headache specialist, neuro-ophthalmologist and adjunct professor at Thomas Jefferson University, tells us at the 2022 Migraine World Summit, “In the early ’90s, the triptans came along. And the triptans were specifically designed to treat migraine; they targeted, directly, the serotonin receptors, and they changed people’s lives. So, you know, triptans and some of the ergotamines were the first targeted therapies specifically made for migraine.”²

If one triptan doesn’t work for you, another triptan might.

Each type of triptan has a slightly different effect on the body. For example, the half-life of frovatriptan is 26 hours compared with sumatriptan, which is 1-4 hours. Triptans have a greater than 50% efficacy rate for most people. Some people may respond to one triptan and not another, or find that one triptan works better than another. Deciding which triptan is best for you is determined by a discussion with your doctor. Your health profile, diagnosis, and personal medical history will be taken into account.^2,5,13

Triptans can be taken orally, through a nasal spray, or via a subcutaneous injection. Nasal sprays and injections are well-suited for people who may experience nausea and vomiting with migraine attacks, making them unable to absorb oral medication in their system. Nasal spray and injections are also faster-acting, which makes them especially helpful for people who wake up with a migraine.

Triptan Dosage and Administration

Below are the seven triptans available for the acute treatment of migraine.⁶

In an interview with Dr. Messoud Ashina in 2022, Paula Dumas of the Migraine World Summit asks: “Is there any reason why everyone shouldn’t use a triptan, [or newer drugs such as a] ditan, or a gepant?”

Dr. Ashina replies,

Triptan Efficacy

Published in September, 2024, a systematic review and network meta-analysis compared all licensed drug interventions for the acute treatment of migraine attacks in adults. Overall, eletriptan, rizatriptan, sumatriptan, and zolmitriptan had the best profiles. They also were found to work more effectively than newer drugs including lasmiditan, rimegepant, and ubrogepant.¹⁷

See the image below, from bmj.com, for more details on the comparisons.

Triptan Side Effects

Side effects of triptans include the following:¹⁸

• Chest Pain (rare)
• Dizziness
• Drowsiness, Fatigue
• Flushing
• Nausea
• Neck Pain
• Sweating
• Tingling, Numbness or a Pins and Needles Feeling in the Hands and Feet 
• Weakness

Triptan Safety in Special Populations

People With Heart Conditions

Triptans are contraindicated, not considered safe, for people with heart conditions and vascular disease like high blood pressure, Raynaud’s, heart attack, stroke, etc. Dr. Gretchen Tietjen, professor emerita of neurology at the University of Toledo, provided insight on this in her interview on “Migraine Changes in Older Adults” during the 2023 Migraine World Summit.²²

Dr. Tietjen says, “One of the things I think that has always vexed people the most, until hopefully recently, now that we have some new drugs that could replace it, but acute medications like the triptans cause vasoconstriction, which means any blood vessel in your body, which has this type of receptor on it — the serotonin receptor of a certain type — if you had that drug in your system, it could cause some — potentially it could cause some vasoconstriction of your coronary artery disease. Now, that is not common at all, but it’s not unheard of.”²²

She adds, “That’s why with those drugs, once a person develops cardiac disease and has had a heart attack or has angina symptoms — which is sort of a warning for a heart attack — it’s thought, ‘do not use that medication anymore.’”²²

Senior Citizens

Triptans are regularly prescribed to seniors without major vascular or cardiac concerns; however, more studies are needed on the 65+ population. Two recent studies suggest older adults using triptans for migraine may have low increased stroke risk. Still, the researchers of those studies advise, “Migraine treatment in the older population requires careful consideration of increased medical comorbidities.”

Children and Adolescents

Triptans are prescribed less often in children; ibuprofen is recommended for initial treatment for those under age 12.²¹ Rizatriptan is the only FDA-approved triptan for use for all children ages 6-17.²⁰ 

In adolescents, sumatriptan/naproxen tablets, sumatriptan nasal spray, and rizatriptan or almotriptan oral-dissolving tablets are recommended for initial treatment. Abortive medications are more effective when used early after the onset of migraine in adolescents and adults.²¹

Pregnant Women

During the 2017 Migraine World Summit, Paula Dumas and Dr. Matthew Robbins, associate professor of neurology at Weill Cornell Medical College, New York-Presbyterian Hospital, discussed migraine treatment during pregnancy. In regard to triptans, he says, “The tradition has always been to avoid triptans in pregnancy because of the potential for birth defects or the potential to reduce blood flow through the placenta, but recent large studies and registry studies over a decade or more have not shown a major signal of elevated birth defects when compared to the general population, so there is a trend nowadays of using triptans on occasion in those who already have a track record for responding to them before their pregnancy, as long as it’s done in moderation.”¹⁹

Nursing Mothers

Dr. Robbins also shared advice on triptan use during breastfeeding. He says, “The general principle for breastfeeding is looking at the ratio of a medicine in milk to plasma, and every medicine has this known ratio, so those that have these lower ratios are safer than those that have the higher ratios, and it has to do with protein binding and other features.”

He adds, “So, for example, of all the triptan medications, eletriptan, which has the brand name Relpax, is probably the safest, because it’s cleared the least into breast milk. But also other considerations have to be taken into account; so, for example, if a woman is breastfeeding a baby who was born premature, and there are crucial concerns about neurological development of that baby, you might really avoid any medications that might impact alertness or awareness that could have deleterious consequences.”¹⁹

When to Use a Triptan

Triptans work best if taken at the first signs of a migraine attack, or within the first two hours of migraine onset. The earliest signs of a migraine attack include prodromal symptoms such as yawning, fatigue, irritability, and food cravings. At the first signs of a migraine attack, it is up to the individual to determine if they will choose a triptan to abort the migraine or use an NSAID, analgesic, or other treatment option.¹⁰

Combinations/Layering Strategies

Triptans, NSAIDS, and Analgesics

Triptans work well with some non-steroidal anti-inflammatory drugs (NSAIDs).¹ 

Common over-the-counter NSAIDs include naproxen (e.g., Aleve) and ibuprofen (e.g., Advil, Motrin). Some triptans, such as sumatriptan, also come with naproxen added.¹ Triptans also work well with acetaminophen (e.g., Tylenol, FeverAll), which is a common analgesic. Some people choose to use an NSAID and/or acetaminophen at the first signs of a migraine attack since:

a) Triptans are not to be used more than 10 times per month.
b) Not all migraine attacks may require a triptan. 

If the migraine attack recedes, the individual may not need to use a triptan. If the attack does not recede within the first two hours of symptom onset, then a triptan is still available for use.

Triptans and Medication Overuse Headache (MOH)

Triptans should not be used more than 10 times per month. This makes triptans effective for the acute treatment of episodic migraine less than 10 days per month. Episodic migraine is defined as having less than 15 attacks per month.⁸ 

When triptans are overused, or overused in conjunction with NSAIDs or acetaminophen, people can develop a complication called medication overuse headache (MOH). MOH can present as a daily dull headache or a daily migraine. In most cases, reducing the use of the offending medication will reverse MOH. In some cases, MOH leads to chronic migraine. Chronic migraine is a condition defined as 15 or more headache days per month, with at least eight of those being migraine attacks, for at least three months.^8,11

Often people living with migraine are continually searching for the best treatment option for them. If they have tried one triptan and it was not effective, or the side effects of the triptan were considerable, it may be helpful to try other triptans before moving to more expensive or invasive treatment options. 

Paula Dumas of the Migraine World Summit asks: “People who might be at risk for medication overuse headache, or rebound: Are we finding that gepants are a better option for those folks?”

Dr. Dodick, director of the headache program at the Mayo Clinic in Arizona, responds:

Triptans and Ditans

Ditans are a new class of drugs for the acute treatment of migraine. Ditans became available for use in the United States healthcare system in 2019. Both ditans and triptans work by blocking the release of CGRP, but unlike triptans, ditans do not dilate blood vessels. This makes ditans safer for people living with migraine and vascular diseases, such as cardiovascular disease, Raynaud’s syndrome, high blood pressure, diabetes, or stroke. Ditans are more expensive than triptans and are not as readily accessible in as many countries as triptans.¹⁰

Triptans and Gepants

Gepants are a new class of drugs for both the acute and preventive treatment of migraine attacks. This represents a recent breakthrough for migraine management. Gepants are CGRP antagonists that block CGRP receptor sites, but unlike triptans they do not constrict blood vessels or arteries. This makes gepants safe for people living with vascular diseases, such as cardiovascular conditions, Raynaud’s syndrome, high blood pressure, diabetes, or stroke. Gepants are more expensive than triptans and are not as readily accessible in as many healthcare systems worldwide as triptans.⁷

During their 2021 Migraine World Summit interview, Paula Dumas and Dr. David Dodick discuss geptans and how they differ from triptans.

In the video below, Dr. Dodick discusses the incredible significance of these new treatment options, both for patients and practitioners.

Triptans and Botox

OnabotulinumtoxinA, Botox, is a neurotoxin designed to block nerve stimulation and relax muscles.⁷ Injections are given in the face, head, and neck. Botox is available for people living with chronic migraine. Unlike triptans, Botox was not specifically designed for migraine treatment and does not target CGRP or blood vessels. However, many people find it an effective treatment to help prevent acute migraine attacks. Botox is accessible in most countries and is more expensive than triptans.

Triptans and Opiods

Opioids are a broad class of drugs that enhance pleasure and block pain receptor sites in the brain. They are most commonly used following surgery and for the treatment of chronic pain conditions. Opioids are not recommended for the treatment of migraine due to their addictive nature.

Drug-to-Drug Interactions²³

Triptans with MAOIs

The enzyme monoamine oxidase (MAO) in MAOI antidepressants breaks down some or all of the following four triptans: almotriptan, rizatriptan, sumatriptan, and zomitriptan. Eletriptan, frovatriptan, and naratriptan, however, are not broken down by MAOIs and, therefore, are better options for people with migraine on MAOIs.

Triptans with SSRIs and SNRIs

People on triptans and an SSRI (serotonin reuptake inhibitor antidepressant) or SNRI (serotonin norepinephrine inhibitor antidepressant) run the risk of developing serotonin syndrome, since triptans and these antidepressants each affect serotonin levels. The rare condition can cause confusion; changes in blood pressure; increased heart rate and sweating; and muscle changes like twitching, jerking, and clumsiness. While serotonin syndrome is rare, it’s good to know about it, so it can be recognized and treated should it occur.

Triptans with Ergots

No large studies have been conducted to evaluate the effect, so the exact narrowing process is unknown, but ergots may constrict arteries, and triptans are estimated to constrict normal heart arteries by up to 20%. To avoid potentially harmful blood vessel narrowing, triptans and ergots are not to be taken on the same day.

The Bottom Line

Triptans are a class of drugs used to acutely treat migraine attacks. There are seven different types of triptans, and each works a little differently. If one triptan doesn’t work well for a person’s migraine attacks or the side effects of the triptan are considerable, another triptan may be tried and found to work better. While shown to be highly effective when taken early during an attack, and often considered a first-line migraine treatment, triptans are not a good fit for everyone. Medication overuse headache, MOH, or a history of cardiovascular disease are two reasons why doctors may choose a different medication, such as a gepant or ditan, instead of a triptan.

The landscape of medical treatment for migraine has evolved considerably over the years. It now offers a variety of medications to help alleviate acute attacks and prevent them in the future.

In this article you will learn more about the numerous medications offered to people with migraine today. It should allow you to easily prepare for your next doctor’s appointment, armed with knowledge.

Acute Medication for Migraine Headache

When you are experiencing a migraine attack, acute medication can be taken to stop or minimize the intensity and duration of the pain as well as other migraine symptoms. 

Acute medication for migraine includes a range of options, from simple pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain in general, to triptans and gepants, which are specially developed to treat migraine.¹ 

Acute medications are available in various forms, including oral pills, dissolvable tablets, nasal sprays, and injections. If you tend to vomit during migraine attacks, using nasal sprays or injections can help ensure that the medication remains in your system.

Achieving the Most Effective Acute Treatment

Most people who experience migraine attacks should consider acute medication. When effective, acute medication can significantly relieve attacks in either severity or duration, or both.

For the best possible effect, you should take your acute medication at the first sign of a migraine attack. Dr. Andrew Charles says that there have been multiple studies showing that treatment when pain is mild is beneficial.

“If you treat your migraine attacks when the pain is mild, studies show that there is a greater chance of reaching a pain-free endpoint, or pain relief within a certain period of time. In addition, the chance that an attack will recur is actually reduced,” says Dr. Charles.

Delays in taking acute medication can lead to increased pain, greater disability, and a more significant impact from the headache. The benchmark of an effective acute treatment is “back to function” within two hours of treatment.

In many cases, a combination of medications may be necessary to achieve adequate relief. However, do not mix medications on your own; these must be prescribed by your doctor. 

When experiencing frequent migraine attacks, it can be challenging to avoid overusing acute medications. Using various types of medication, like over-the-counter pain relievers or triptans combined with NSAIDs for 10 days or more each month, can lead to medication overuse headache (MOH),² also known as rebound headache. This can result in even more frequent migraine attacks and increased pain. You can read more about medication overuse headache and how to avoid it below. 

Consider keeping a migraine diary to track your migraine attacks, what medication you use and its effects. There are several apps available for this purpose that you can download and easily access from your phone.

Different Types of Acute Migraine Medication

There are several different types of acute medication for migraine attacks. These include:

• ditans
• pain relievers (analgesics)
• NSAIDs
• triptans
• ergotamine
• gepants

First-Line Acute Treatments for Migraine

If you are experiencing mild to moderate migraine attacks, first-line acute treatment includes: pain relievers (analgesics). For example:¹⁰

• aspirin (Bayer)
• acetaminophen (Tylenol)
• NSAIDs including ibuprofen (Advil)

If you are experiencing moderate to severe migraine attacks, first-line acute treatment includes:¹⁰

• Triptans, including:
  • sumatriptan (Imitrex) —  this is the triptan commonly prescribed before trying others.
  • zolmitriptan (Zomig)
  • eletriptan (Relpax)
  • rizatriptan (Maxalt)
  • almotriptan (Axert)
  • frovatriptan (Frova)
  • naratriptan (Amerge)

It may take awhile to find a medication that is effective and well tolerated. Up to three different triptans may be tried via various routes of administration before physicians will look to another class of drugs, including gepants and ditans.¹⁰ Gepants and ditans are also prescribed to individuals who are unable to take triptans since these newer drugs don’t constrict blood vessels.¹⁰

• Gepants (CGRP small-molecule receptor antagonists), including:
  • rimegepant (Nurtec ODT, Vydura)
  • ubrogepant (Ubrelvy)
  • zavegepant (Zaczpret)

• Ditans (selective 5HT1F receptor agonists) such as lasmiditan (Reyvow)

Other Medications Available for the Acute Treatment of Migraine

Additional prescribed medications include ergotamine derivatives, such as dihydroergotamine (DHE). Many physicians also recommend treating migraine attacks with neuromodulation devices such as CEFALY and Nerivio (more on these below).

Also, if you experience nausea during your attacks, anti-nausea medication (antiemetics) can not only keep the acute medicine you take in your system but also enhance the absorption of it.

Over-the counter (non-prescription) options in anti-nausea medication include dimenhydrinate (Dramamine) and diphenhydramine (Benadryl). Prescription antiemetics include metoclopramide (Reglan) and ondansetron (Zofran).

How to Know What Acute Medication to Take and When

According to Dr. Friedman, people living with migraine often have different kinds of attacks. Treatments should not only be tailored to each individual patient, but also to their specific type(s) of attacks.

“Share with your doctor the typical timeframe of a migraine attack, from when you first become aware of an attack, to then when the pain starts. How long does it take for your medication to work? Does the headache come back? What percentage of the time is your acute medication effective? This information may help you to get a better acute treatment plan,” Dr. Friedman explains.

How to Avoid Medication Overuse Headache (MOH)

Medication overuse headache (MOH) is a type of headache that occurs from using too much medication for an existing headache disorder, like migraine, and is common among individuals with 15 or more headache days per month.³ Medication overuse headache can occur when using various types of medication, like over-the-counter pain relievers or triptans combined with NSAIDs, for 10 days or more each month.⁴ 

Adding preventive methods to reduce headache frequency is important to prevent medication overuse headache. Another strategy to avoid medication overuse headache is to use gepants for preventive and/or acute treatment. Gepants have not been shown to contribute to medication overuse headache unlike other acute treatments.⁵

Preventive Medication for Migraine

The primary goal of preventive medication for migraine is to lessen the impact of the condition by reducing either the frequency or severity of migraine attacks — or both.

Preventive medication includes a range of options. These include antidepressants, beta blockers, calcium channel blockers, anti-seizure medications and Botox. There are also preventive medications developed especially for migraine, such as Calcitonin Gene Related Peptides (CGRP) monoclonal antibodies. 

The medication comes in various forms, including oral pills, injections, and intravenous (IV) drugs. Successful preventive treatment for migraines is measured by its ability to reduce the disease burden and improve quality of life.

When to Start Using Preventive Medication for Migraine

Effective preventive migraine treatment starts with an accurate diagnosis, which may involve ruling out other potential causes of your symptoms. Whether or not you should take preventive medication depends on the number of migraine attacks you experience per month and how much they affect your daily life.

Practitioners suggest starting migraine preventive drug therapy when one or more of the following conditions is present:¹¹

• You have more than three migraine attacks or at least eight headache days in one month.
• You have severe, debilitating headache attacks despite acute treatment.
• You have contraindications to acute medication or can’t tolerate its side effects.
• You have medication overuse headache.
• You have hemiplegic migraine, basilar migraine, or migraine with prolonged aura.
• You prefer to go on a preventive treatment.

Tips to Find Your Most Effective Migraine Prevention

• Don’t get discouraged if the first medication you try doesn’t have the desired effect. Finding a preventive medication that works for you may require some trial and error. 
• Different preventive medications can complement each other, and you might need to use more than one.
• Keep a migraine diary to track your attacks, symptoms, and the effects of treatments.
• An effective preventive treatment is typically defined by a 50% reduction in the frequency or severity of attacks.
• If your doctor tells you they’ve tried everything or run out of options, it may be time to consider another doctor. There are many options and strategies to consider for someone who knows how to treat patients with migraine disorder.

Different Types of Preventive Migraine Medication

First-Line Treatments for Migraine Prevention

Options include:

• Anti-seizure medication (anticonvulsants), including divalproex (Depakote) and topiramate (Topamax)
• Blood pressure lowering medication, including beta blockers, such as propranolol (Hemangeol); also, calcium channel blockers, such as verapamil (Verelan)

Other Approved Treatments for Migraine Prevention⁹

• Antidepressants, such as amitriptyline (Elavil) 
• Gepants, including rimegepant (Nurtec ODT) and atogepant (Qulipta)
• Calcitonin Gene Related Peptides (CGRP) monoclonal antibodies (mAbs), for example: erenumab (Aimovig), galcanezumab (Emgality), fremanezumab (Ajovy), and eptinezumab (Vyepti) 
• OnabotuliniumtoxinA (Botox)

Due to comorbidities, other conditions you may have in addition to migraine, certain preventive medications may be better than others for you.⁹ For instance, calcium channel blockers may be preferred if you have dizziness or vertigo. If you have insomnia and/or depression, a tricyclic antidepressant may be chosen for you.

Neuromodulation Devices for Migraine

How Neuromodulation Devices Work

Neuromodulation devices, sometimes referred to as nerve stimulation devices or neurostimulation devices, modulate the activity of different nerves such as the occipital nerve, trigeminal nerve, vagus nerve, and the supraorbital and supratrochlear nerves in the forehead. Some neuromodulation devices are used for preventive treatment, some for acute treatment, and some have both options. These devices typically require a prescription.

When to Try Neuromodulation Devices

• If you experience side effects from medication (Neuromodulation devices have limited side effects because they are not absorbed in the body.)
• If you are in need of using acute medication more than 10 days a month
• If you are under 18 (Some neuromodulation devices are approved for adolescents.)

Food and Drug Administration (FDA)-Approved Neuromodulation Devices for Migraine:⁸

• CEFALY 
• Nerivio 
• gammaCore 
• SAVI Dual 
• Relivion MG 
• HeadaTerm 2

How to Find the Right Migraine Treatment for You

If you are living with migraine and it is negatively impacting your life, it is recommended that you consult a headache specialist or a neurologist. You may experience difficulty in finding or getting in to see a headache specialist, as they are in short supply. Keep in mind that neurologists aren’t necessarily headache specialists, but they tend to treat a lot of patients with migraine.

Ensuring that your treatment is specifically tailored to address both acute attacks and preventive care is crucial. Various types of medications, both acute and preventive, work well together. Consider keeping a migraine journal to track the effects of different medications.

Additionally, consider non-drug therapies such as neuromodulation devices, chiropractic care, cognitive behavioral therapy (CBT), and lifestyle changes like regular exercise and consistent sleep routines.

Supplements to Consider

Supplements are another class of treatment that often comes up when talking about migraine. 

Dr. Alexander Mauskop, director and founder of the New York Headache Center, and a board-certified neurologist and headache specialist, explains which supplements he would typically recommend for those living with migraine.

“If we don’t have any blood work to help us determine what supplements to use, we would first recommend magnesium because it has the most scientific evidence, and about 50% of people are deficient in magnesium. Second, the most proven supplement would be coenzyme Q10. We have a very large study looking at 1,550 people with migraine, and fully one third is deficient in CoQ10. My next recommendation would be a vitamin B2 — riboflavin. And then we also recommend herbal products such as feverfew. Another herbal supplement that I recommend is boswellia — frankincense.”

Improvement: What to Expect

For those living with frequent migraine attacks, any form of relief, whether small or significant, is greatly appreciated. However, according to Dr. Stewart J. Tepper, professor of neurology, people often settle for less than they should.

“I’m never satisfied until people are really not having any disability or impact from their migraines, and their function across all aspects of their life is back to normal,” says Dr. Tepper.

“If somebody has a very good response to a subcutaneous monoclonal antibody, but is still having a migraine attack or two per week, where previously they might have had 20 headache days in a month, it’s a pretty dramatic improvement for that person. But it may not be as good as they can get.”

Dr. Tepper suggests multiple ways to get an even greater drop in headache days, and improvement in quality of life.

“One way is to move from a subcutaneous injection of a monoclonal antibody once a month to an intravenous monoclonal antibody, and even move to the highest dose of that intravenous monoclonal antibody. Another option is to add onabotulinumtoxinA, or Botox. Sometimes the combination of the two will have an additive, or a synergistic effect,” says Dr. Tepper. He adds, “We can also consider a switch to the daily or every-other-day oral medications and combining gepants. All of these offer opportunities for people to do even better.”

Summary: Medication for Migraine Headaches

Medication for migraine headaches includes both acute and preventive medication. Most people with migraine should consider acute medication to effectively stop migraine attacks. 

If you are experiencing migraine attacks four or more days per month, you can talk to your doctor about preventive treatment. If you are severely burdened by your migraine attacks, two a month is enough to consider preventive medication. See the full list of recommendations under the section When to Start Using Preventive Medications for Migraine.

It’s important to use a migraine diary to track migraine attacks, symptoms, and the effects of treatments used. Above all, remember the process takes time. Finding the right treatment, both acute and preventive, is often a process of trial and error. Don’t lose faith that there is treatment out there that will be able to help you.

Headaches are a shared experience impacting people across all walks of life. Those experiencing them move along and manage the best they can, tapping formal and informal supports, trying a spectrum of remedies, and taking one day at a time.

However, there exists an elusive, complex, and problematic level of headache … the severe headache. This is a whole different ball game warranting further discussion since severe headaches can and do have a significant impact on those experiencing them.

This article dives into several Migraine World Summit interviews with renowned headache experts. They will explain what severe headaches are, their causes, and, most importantly, when and how to get help. Khalil Gibran once said, “Your pain is the breaking of the shell that encloses your understanding.” This touches deeply on managing a severe headache, where the struggle may bring insight and resilience. This information aims to help people living with and managing severe headache conditions feel more informed, empowered, and safe.

Common Causes of Severe Headache

What is a severe headache? Differing definitions and assumptions exist. It may be surprising to know severe headaches do not often occur in isolation, nor are they the main instigator. Also, many health conditions and headache variations fall under the severe headache spectrum (i.e. primary and secondary headache). Below are medical diagnoses where severe headache is a foundational component:

Common Diagnoses Featuring Severe Headache

Avoiding Medication Overuse Headache

As mentioned in the table above, overuse of medications, especially over-the-counter or prescription pain relievers, can lead to a headache returning as the medication wears off, creating a cycle of dependency and constant head pain. These are commonly referred to as rebound headaches.

During the Migraine World Summit’s 2016 event, Dr. Alan Rapoport stated, “They can hurt their liver. They can hurt their kidneys. What I’m interested in is it’ll hurt their [headache] because they’ll end up having more [headache], and the stuff will stop working on them, and they come in and say to me, ‘I keep taking this medicine, and my headache is still bothering me even more,’ and, again, they don’t understand that they’re actually unintentionally contributing to the headache.”¹ Additionally, some medications targeting various other conditions (e.g., blood pressure or hormones) can trigger headache as a side effect.²

Dr. Gisela Terwindt explains what medications can cause medication overuse headache, as well as approaches to treatment.

Symptoms of Severe Headache

To understand severe headache it is important to identify unique symptoms. This includes intensity of pain, associated symptoms, as well as duration and frequency.³

Pain Intensity and Location

Pain intensity and location can vary greatly depending on the headache type. For example, migraine attacks can cause intense, throbbing pain on one side of the head. At the same time, a tension-type headache is typically constant, dull aching around the forehead or back of the head and neck. On the other hand, cluster headache involves excruciating pain, usually around one eye or side of the head, in cyclical time patterns.

Associated Symptoms

Accompanying symptoms of severe headache often include nausea, vomiting, sensitivity to light (photophobia), sensitivity to sound (phonophobia), and visual disturbances (aura). These travel alongside the headache pain, providing clues to the headache type. For example, migraine attacks frequently involve these additional symptoms. At the same time, cluster headache attacks can cause eye redness and tearing on the affected side. For other severe headache, such as thunderclap headache, other less-known associated symptoms can exist, such as speech difficulties, dizziness, seizures, confusion, vision changes, numbness, etc.⁴

Duration and Frequency

How long and how often head pain occurs assists in diagnosis. Migraine typically lasts several hours or days and may occur once in a while (episodic) to at least half of the month (chronic). Cluster headaches are often short, intense episodes lasting but minutes, occurring multiple times a day over weeks or months. 

Another severe headache type is the thunderclap headache, which is sudden and severe, reaching maximum intensity within 60 seconds, and lasting at least five minutes. Additionally, hemicrania continua headache, which features persistent and unilateral pain that fluctuates in intensity but never fully disappears, is often accompanied by autonomic symptoms, disruptions to automatic functions. One can start to see how complex understanding and treating headache is since there are several combinations related to headache duration and frequency.

When a Serious Headache Requires Immediate Attention

When is a headache sufficiently serious to warrant outside help? While many times a headache can be treated at home, specific symptoms signal the need for urgent medical support. Recognizing these red flags is critical to avoid serious health complications. 

One tool that can help identify these warning signs is the SNNOOP10 tool, a clinical guide used by healthcare providers in assessing headache symptoms. The SNNOOP10 tool covers areas such as:

• Systemic symptoms (i.e., affecting the whole body, such as fever or weight loss)
• Neurological signs (e.g., vision changes, speech issues)
• New onset in people over 50 years old
• Occurrence with positional changes (i.e., when you stand up or move around)
• Onset during pregnancy
• Previous headache history
• Plus 10 other signs highlighting underlying conditions such as infection, vascular disorders, or structural brain issues.⁵

A tool like this can help you tell the difference between a typical headache and one that might indicate a life-threatening condition. The following are some key warning signs, which align with the SNNOOP10 criteria, indicating a headache may require immediate attention by a healthcare provider.⁶

Sudden Onset of Severe Headache

Imagine a headache that appears to come out of nowhere, and you would describe it as the worst headache of your life. For example, a pain so agonizing and disorienting that it causes you to pass out. These sudden and intense headaches can signal more critical conditions like the ones discussed earlier (e.g., subarachnoid hemorrhage from an aneurysm rupture). These types of headaches often quickly worsen and require immediate medical attention, as they can be life-threatening.

Headache with Neurological Symptoms

Imagine experiencing an intense headache but also slurring your words or noticing a side of your face drooping. As stated before, a headache accompanied by neurological symptoms (e.g., vision changes, speech difficulties, weakness, numbness, and seizures) could suggest a possible underlying, serious problem impacting the brain, such as a stroke or brain tumor. Time-sensitive evaluation by a healthcare professional is recommended when these symptoms occur.

Headache After a Head Injury

If a headache persists or worsens following a concussion/head injury, other problems may be involved (e.g., brain swelling or bleeding). That’s especially so if the head pain is accompanied by confusion, dizziness, vomiting, or changes in alertness. For example, imagine having a head injury and initially feeling fine. But then, you start experiencing a relentless, worsening headache. You might become more irritable, light-headed, and confused. Prompt medical assessment is needed to rule out serious injuries.

Persistent or Worsening Headache

Envision experiencing a headache for several weeks. Still, the pain has become sharper and more intense without relief from regular painkillers. You might also start feeling nauseous to the point of vomiting. Over time, a constant or worsening headache can be a sign of severe conditions (e.g., a brain tumor or a build-up of fluid in the brain’s ventricles). A headache that transitions from mild to severe and does not stop needs a more thorough investigation.

Headache with Fever or Stiff Neck

Severe headache, fever, and stiff neck can sometimes signal an infection. Meningitis, for example, is an infection of the membranes around the brain and spinal cord. An individual with meningitis might become sensitive to light and develop a rash, fever, and pounding headache.⁷ This mix of symptoms requires immediate medical intervention to prevent severe, possibly life-threatening complications.

Mental Health Considerations

Severe headache can have a significant impact on mental health, contributing to anxiety, depression, and an overall reduced quality of life. If you experience a daily headache, you might feel trapped by your pain. Over time, you may withdraw from social activities and become increasingly anxious about the next attack. Persistent pain and discomfort can lead to emotional distress, irritability, and difficulty concentrating — further exacerbating mental health challenges. This ongoing struggle can leave you feeling hopeless and frustrated, making it essential to seek support. 

At the 2018 Migraine World Summit, Dr. Dawn Buse discussed migraine and two of its common comorbidities, anxiety and depression. She shared, “They are their little evil team of three. I’m thinking of the arch-villains in a comic book with these three. In research, we have noticed that when we can treat any one of them, the others get better. If we just reduce headache days somewhat, migraine, depression, and anxiety get better.”⁸ 

Access to support networks and professional guidance can help you manage pain and provide coping strategies, fostering resilience and improving mental and physical well-being.

Diagnosis and Medical Evaluation

Where to Go for Care

Immediate consultation (at an emergency room) is crucial if your headache is sudden and intense, accompanied by neurological symptoms, or follows a head injury. For persistent or worsening headaches, regular visits to your general physician or neurologist can help identify and manage underlying causes. So, what happens when someone reaches out for help in dealing with severe head pain?

Diagnostic Tests and Procedures (CT Scan, MRI, etc.)

To determine the cause of severe headache, health professionals may recommend various tests and procedures. Tests like CT scans and MRIs can reveal issues in the brain that might be causing pain. Blood tests check for infections or other underlying conditions. In some cases, a lumbar puncture (i.e., spinal tap) can rule out conditions such as meningitis or a subarachnoid hemorrhage.⁹

Importance of an Accurate Diagnosis

An accurate diagnosis is necessary for effective treatment and management of severe headache, and identifying underlying causes. Whether the head pain is due to migraine, cluster headache, or potentially life-threatening conditions like a brain tumor or aneurysm, understanding the exact cause allows for strategic treatment, quality of life improvement, and prevention of further issues. 

This is not always a straightforward or smooth process. Sometimes, you must self-advocate and be assertive when navigating the complex web of healthcare systems. Joe Coe from the Global Healthy Living Foundation emphasizes this: “If you feel like you’re going to be shamed or questioned about who you are as a person, you’re not going to live that indignity and seek care. We know that people are delaying treatment to routine wellness visits because their primary care physician isn’t affirming of their identity or sexual orientation.”¹⁰

How Tracking Health Data Helps

For an accurate diagnosis, doctors gather detailed health information. Be prepared to track important data and answer questions about themes discussed in this article, such as:

• Onset, duration, and frequency of headache
• Associated symptoms like nausea, light sensitivity, or aura
• Medical history, including any past head injuries, family history of headache, and current medications/treatments
• Potential triggers

These clues help doctors paint an accurate picture (e.g., type of headache, more serious conditions, etc.) and develop a holistic treatment plan tailored to your needs. For instance, noting if your head pain worsens after physical exertion or specific stressors can guide more targeted testing.

Also, by tracking your symptoms (in a diary or tracking app like Migraine Buddy), you can capture insights consistently, improving communication and navigation within the healthcare system and enhancing the chances of an accurate diagnosis. This also allows you to better understand your condition and recognize potential triggers or patterns, leading to improved lifestyle management.

Preventing Strategies: A Balanced Approach

While certain severe headache conditions like migraine and cluster headache may have specific triggers, prevention often comes down to maintaining a healthy, balanced lifestyle. For headache caused by other factors, such as tumors, the best we can do is stay as healthy as possible. Although some individuals may experience a severe headache despite being in good health, adopting a balanced lifestyle can enhance recovery and management of these conditions. For more insights on managing severe chronic headache conditions, check out a related article here.

Summary

A severe headache isn’t just an inconvenience. It can profoundly impact your life and  well-being. This article provides an overview of the complexities of severe headache, exploring various causes, triggers, and associated conditions. Recognizing warning signs and understanding when to get help early can prevent serious complications. Gaining a better understanding of severe headache conditions allows for making more informed decisions about your health, improving your quality of life, and helping you navigate the challenges that come with severe head pain.

Resources and References

Links to outside organizations and articles are provided for informational purposes only and imply no endorsement on behalf of the Migraine World Summit.

Further Reading

• International Headache Society. (2018). The international classification of headache disorders, 3rd edition (ICHD-3). Cephalalgia, 38(1), 1-211. https://www.ichd-3.org/ 
• National Institute of Neurological Disorders and Stroke. (2023). Migraine information page. https://www.ninds.nih.gov/health-information/disorders/migraine 
• World Health Organization. (2016). Atlas of headache disorders and resources in the world 2011. World Health Organization. https://www.who.int/publications/i/item/9789241564212

Support

• Migraine World Summit: gathers leading headache experts from around the world to share the latest research, treatments, and strategies for managing migraine. The summit offers extensive video interviews, articles, and resources for individuals dealing with migraine.
• European Headache Federation (EHF): provides educational resources, conducts research, and collaborates with other organizations to enhance understanding and treatment of headache.
• Migraine Trust (UK): offers a wealth of resources including information on treatments, support groups, and advocacy for people living with migraine. They also conduct and support research initiatives focused on migraine.
• American Migraine Foundation (AMF): provides comprehensive resources, including educational materials, research updates, and support networks for those living with migraine. Their global outreach includes webinars and community support initiatives.
• Migraine Canada: offers educational resources, treatment information, and a community forum for individuals suffering from migraine. They also collaborate with international organizations to enhance migraine awareness and research.
• International Association for the Study of Pain (IASP): promotes the study of pain, including headache. They provide resources for both professionals and patients, host international conferences, and support global pain research.
• The World Federation of Neurology (WFN) – Headache Group: focused on improving the care and management of headache globally. They offer educational resources and guidelines, and promote research in the field of headache disorders.
• Global Patient Advocacy Coalition (GPAC): advocates for patients with chronic pain conditions, including migraine, on an international scale. They work to influence global health policies and provide resources and support for patients and caregivers.