If you live with chronic migraine, you may find that you need to switch treatments at some point. Your current treatment may stop working, and developments in research lend to new treatments that may be more effective than your current treatments.

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

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

If you need a new treatment for your migraine attacks or you would like to consider one, it’s important to talk to your neurologist first. They should be able to answer your questions so you know what to expect from any migraine treatment option. Read on for seven questions to ask your neurologist or primary care provider about new migraine treatments.

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 treatments are generally split into two categories: emergency treatment (for active migraine attacks) and preventive treatment (so you don’t get migraine attacks).

Emergency treatments (also known as abortive or acute treatments) include:

• Pain relievers, including ibuprofen (such as Advil) and naproxen (such as Aleve)
• Pain relievers mixed with caffeine, including over-the-counter options like Excedrin Migraine, which contains aspirin, acetaminophen, and caffeine
• Serotonin (5-HT) 1F receptor agonists, such as lasmiditan (Reyvow)
• Triptans, such as sumatriptan (Imitrex), zolmitriptan (Zomig), and eletriptan (Relpax)
• Oral calcitonin gene-related peptide antagonists, like ubrogepant (Ubrelvy) and intranasal zavegepant (Zavzpret)
• Opioids, such as oxycodone
• Ergot alkaloids, such as dihydroergotamine (Migranal)

They may also include symptom-specific medications, like anti-nausea pills.

Preventive treatments include:

• Some antidepressants, such as amitriptyline (Elavil) and venlafaxine (Effexor)
• Blood-pressure medications, including beta blockers like propranolol (Inderal, InnoPran XL) and metoprolol (Lopressor), as well as calcium channel blockers such as verapamil (Verelan, Calan)
• Some anti-seizure medications, such as topiramate (Topamax), gabapentin (Neurontin), and valporate (Depacon)
• Calcitonin gene-related peptides (https://www.mymigraineteam.com/resources/what-is-cgrp-and-how-does-it-affect-migraine) monoclonal antibodies, like atogepant (Qulipta), eptinezumab-jjmr (Vyepti), erenumab-aooe (Aimovig), rimegepant (Nurtec ODT), and fremanezumab-vfrm (Ajovy)
• Nerve-blocking agents such as onabotulinumtoxinA (Botox) injections

You may need both emergency and preventive treatments, at least for a while. Your health care providers can help you find the ones that will get you migraine relief.

2. How Effective Is This Treatment?

Research on migraine and migraine treatments is ongoing, so it’s important to ask your health care professional what the latest information says about how effective any new treatments might be. If a new medication is likely to be more effective than your current one, it might be time to switch even if the current one is still somewhat effective for you.

Asking about effectiveness can also help you know what to expect. If a medication is shown to eliminate all migraine symptoms in research studies, then that might be a reasonable expectation for you. If it only works 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?

Different people experience different migraine symptoms. While throbbing migraine pain is a common symptom, so is nausea (sometimes with vomiting), and a powerful sensitivity to both sound and light. Others experience auras, which are neurological symptoms of migraine that include tingling in the extremities and seeing flashing lights. Symptoms can last for a few hours or a few days and may be experienced up to several times a week.

It’s important to not only keep track of and know your symptoms but to also find treatments that are effective at treating those specific symptoms. This may be especially true for emergency medications. If you don’t have much head pain, for instance, it doesn’t make sense to focus on painkillers. You might need an anti-nausea medication instead. Focusing on your specific symptoms will help you improve your overall quality of life and sense of well-being while living with migraine.

4. How Does This Treatment Work?

You should ask your neurologist for a simple explanation of how any new migraine treatment works. While you may not want or need to understand the chemical reactions that make your treatment effective, basic knowledge of what each medication does can help you take charge of your health and advocate for yourself if necessary.

If your doctor is unable to tell you how a treatment works, you may be able to find information online. That way, you can understand what you’re putting in your body and what is happening when you do it. It can also help you time your medications properly for maximum effectiveness.

5. How Fast Will This Treatment Work?

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

Preventive medications may take longer to be effective. It can take many of them two to six months to be maximally effective. This means that you may need to take them consistently for a longer period of time to see if they help. It also means that you may need emergency treatments so that you’re covered if you get a migraine attack before your preventive treatment is fully effective.

Additionally, you may need to stick with treatments that prevent migraine attacks for them to keep working. Different medications have different dosage methods and schedules, so you and your doctor will need to work out how long and how often you should take them.

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

Like all medications, many migraine treatments come with a risk of side effects. They may not occur for everyone, but it’s good to know what to expect before you start a new treatment. Different treatments can have vastly different side effects, so you’ll want to talk to your doctor about the side effects of each specific treatment you’re considering.

Additionally, some abortive medications aren’t safe to take if you’re pregnant or trying to have a baby. This is information you need about a medication before you start it, so you know that you need to avoid it or find another option if you decide to pursue parenthood.

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 treatment is expensive or very new. Your headache specialist should be able to help you navigate the insurance system and work with you to help you get coverage if that’s necessary.

Some insurance companies require you to try older treatments before they will agree to cover new ones. If this is true for you, your doctor can help you find an older treatment plan to try or document that you have tried them and they didn’t work for you.

Insurance can cause a lot of hassle for 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 insurance isn’t an option, some drug companies offer payment assistance programs for their migraine treatments. Your neurology experts should be able to direct you to these programs and help you use them. Overall, they should be able to help you keep your medical costs as low as possible.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 81,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

Are you considering a new migraine treatment? What questions have you asked your doctor that helped you decide what treatment to use? Share your experience in the comments below, or start a conversation by posting on your Activities page.