If you live with chronic migraine, you may find that you need to switch treatments at some point. Sometimes treatment plans stop working or you may not like a medication’s side effects. Thanks to advances in migraine research, new treatment options may be more effective than your current medication.

Some MyMigraineTeam members have had good experiences changing treatments. “I feel there has been at least a 50 percent improvement with the recent changes in my treatment,” a member wrote.

Others have high hopes for new treatments. “I’m now going to attempt having an infusion done every three months, and I hope that will be the solution,” another member shared.

To learn more about switching migraine treatments and what might work best for you, you can ask your neurologist or primary care provider these seven questions.

1. What Are My New Migraine Treatment Options?

If you’re new to treating migraine or you haven’t changed treatments in a while, it’s important to ask your neurology team what’s available. Knowing your options is the first step toward choosing the right migraine medication for you.

Migraine medicines are generally divided into two categories: acute treatment (for active migraine attacks and migraine pain) and preventive treatment (to reduce the frequency and severity of migraine attacks).

If you’re new to treating migraine or you haven’t changed treatments in a while, it’s important to ask your neurology team what’s available.

Acute, or abortive, treatments include these types of medications:

• Over-the-counter or prescription pain relievers
• Pain relievers mixed with caffeine
• Serotonin (5-HT) 1F receptor agonists
• Triptans
• Oral calcitonin gene-related peptide antagonists
• Ergot alkaloids

Acute treatments may also include symptom-specific medications such as anti-nausea pills.

Preventive treatments include:

• Certain antidepressants
• Blood-pressure medications, such as beta-blockers and calcium channel blockers
• Some anti-seizure medications
• Calcitonin gene-related peptides (CGRP) monoclonal antibodies
• Botox injections

You may need both emergency and preventive treatments. Your health care provider can help you find treatment options to provide migraine relief.

2. How Effective Is This Treatment?

Research on migraine and migraine treatments continues to develop. It’s important to ask your health care professional what the latest information says about the effectiveness of a new treatment option. If your current treatment is still somewhat effective but a new type is likely to work better, it might be time to switch.

Asking about effectiveness can also help you know what to expect. If study findings show that a medication eliminates all migraine symptoms, then that might be a reasonable expectation for you. If it works only a certain percentage of the time or on specific symptoms, keep that in mind while you’re trying it out.

3. Will This Treatment Address My Specific Migraine Symptoms?

It’s essential to talk to your doctor about your specific symptoms. Migraine symptoms vary for everyone. Some people have throbbing migraine head pain, nausea (sometimes with vomiting), and intense sensitivity to both sound and light. Others experience auras, which are neurological symptoms that include tingling in the arms or legs and seeing flashing lights. Symptoms can last a few hours to a few days and may occur several times a week.

It’s important to keep track of your symptoms and discuss them in detail with your doctor when considering a treatment switch. A headache diary or symptom record can be helpful. In the diary, you can keep track of the treatments you use and any migraine triggers you notice. With acute medications, it’s especially crucial to treat your specific symptoms. If you don’t have migraine headache pain, for instance, it doesn’t make sense to focus on painkillers. You might need an anti-nausea medication instead.

Identifying and treating your specific symptoms will help improve your overall quality of life and sense of well-being while living with migraine. You may also want to ask your doctor about supplements, acupuncture, biofeedback, and lifestyle changes that may help with migraine.

4. How Does This Treatment Work?

It can be helpful to ask your neurologist for a simple explanation of how a new treatment of migraine works. You may not want or need to understand the chemical reactions that make your treatment effective, but basic knowledge of what each medication does can help you take charge of your health and advocate for yourself when switching treatments.

Some preventive medications may take two to six months to be as effective as possible.

When discussing treatment changes with your doctor, bring up any information you find online about a new medication. This can help you understand how the medication works and how to use it effectively. Knowing more about your medication can also help you time your medications to get the best results when a migraine attack comes on.

5. How Fast Will This Treatment Work?

When it comes to migraine care, it can be important to understand how fast a new treatment will work. Acute medications usually work relatively quickly because they’re designed to stop symptoms that have already started.

Preventive medications can take a while to begin working. Many take two to six months to reach maximum effectiveness. It’s important to be patient and give the new treatment enough time to show results. While waiting, talk to your doctor about acute treatments to manage migraine attacks that might occur before the preventive medication takes full effect.

A new medication may have a different dosage and schedule. Your doctor will advise you on just how to take a treatment. Always get medical advice before changing your treatment plan.

6. What Side Effects Should I Expect From This Treatment?

Like all medications, migraine treatments come with a risk of side effects, which differ vastly among treatments. Talk to your doctor about the potential side effects of each treatment you’re considering.

Additionally, some acute medications aren’t safe to take if you’re pregnant or trying to have a baby. Be sure to tell your doctor if you’re pregnant or considering pregnancy.

7. What Should I Do if My Insurance Doesn’t Cover This Treatment?

Getting insurance coverage for a new migraine treatment can be tricky, especially if the medication is expensive or very new. Your health care provider or headache specialist should be able to help you navigate the insurance system and get coverage for recommended options.

Some drug companies offer payment assistance programs for their migraine treatments.

Some insurance companies require you to try older treatments before they’ll agree to cover new ones. Your doctor can advise you on first trying another treatment or document that older medications you took didn’t work for you.

Insurance problems are common among people with migraine. “My neurologist decided that I qualified for monthly injections, but my insurance believes otherwise,” one MyMigraineTeam member shared.

“Maybe your neurologist can contact the insurance company and/or the medication company and explain that it is the only thing that might help you,” one member told another.

If your health insurance doesn’t cover a new medication or you lack health insurance, some drug companies offer payment assistance programs for their migraine treatments. Your neurology team can answer questions about these types of programs and help you determine if you’re eligible for assistance.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 84,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

Have you switched migraine treatments? What questions did you ask your doctor to help you decide if a new medication is right for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.