For people living with chronic migraine, the warning signs — blurry vision, neck stiffness, maybe a wave of dizziness — can be all too familiar. These early symptoms might be your cue to reach for your go-to rescue medication, often from a class of drugs called triptans. These drugs are designed to bring quick relief from migraine symptoms. But what if they stop working as well as they used to — or never help at all?

This article covers six steps you can take if your triptan isn’t doing the job. Some people might just need to tweak the timing of their dose or try a new triptan. For others, a different type of medication or a preventive treatment plan might be the answer.

What Are Triptans?

Triptans are rescue drugs for acute migraine. This means that they’re used to treat symptoms of a migraine attack, such as headache, nausea, and sensitivity to light or sound.

Your doctor may refer to triptans as “serotonin receptor agonists.” These medicines work by targeting serotonin (also called 5-HT) in the brain. Serotonin receptor agonists help stop pain signals, reduce inflammation, and narrow blood vessels — all of which can ease migraine symptoms. However, their actions don’t affect migraine attacks.

Triptans are considered a first-line treatment option for migraine headaches. Your healthcare provider might recommend a triptan if over-the-counter pain relief medicines, such as ibuprofen or acetaminophen, haven’t worked well for you. Triptans available in the United States include:

• Almotriptan
• Eletriptan (Relpax)
• Frovatriptan (Frova)
• Naratriptan
• Rizatriptan (Maxalt)
• Sumatriptan (Imitrex, Tosymra)
• Zolmitriptan (Zomig)

Triptans come in different forms, such as pills that you swallow, wafers that dissolve in the mouth, nasal sprays, or subcutaneous injections (shots given under the skin). Not all triptans are available in every form. Triptans don’t prevent migraine, so they should be taken at the first sign of an attack, not before.

Why Triptans Don’t Always Work for Migraine

So, what if your triptan stops working for your migraine attacks? There are several possible reasons they may not be helping — and most are fixable.

• Timing — Triptans work best when taken at the first sign of head pain, not during an aura or after pain becomes intense.
• Dosage or type — Some triptans act quickly but wear off fast, whereas others take longer to kick in but also last longer. Finding the right drug and dose may take some trial and error.
• Overuse — Taking triptans more than twice a week can lead to medication overuse headaches (also called rebound headaches), which may make migraine attacks more frequent.
• Nausea — If you’re too nauseated to keep pills down or your body isn’t properly absorbing the medicine, the triptan may not work as expected.

Migraine is complex, and every brain responds a little differently. If you haven’t found relief from migraine with triptans, the strategies discussed below may help.

1. Try a Different Triptan Medication

If one triptan hasn’t worked for you, another might. Even though all drugs in this class work in a similar way, they don’t act identically in your body. Some, like rizatriptan, start working within 30 minutes but last just a few hours. Others, like frovatriptan, take longer to kick in but stay in your system longer.

If your migraine attacks have changed over time or your current medication causes side effects, talk with your doctor about trying a different triptan. You might ask about eletriptan if you wonder, “What is the strongest triptan for migraines?” Research shows that this drug helps people with chronic migraine about 78 percent of the time and is considered one of the most effective triptans available.

2. Ask Your Doctor About Timing or Different Forms

Sometimes it’s not the medication that’s the problem — it’s how or when you’re taking it. Triptans work best when taken at the first sign of head pain. If your migraine builds quickly, the timing can become even more important.

If nausea or vomiting makes it hard for you to keep pills down, other forms may work better. Some triptans, like zolmitriptan or sumatriptan, are available as nasal sprays or injections under the skin. These options deliver the medicine faster and bypass your stomach.

Your healthcare team can help you figure out which form of triptan is best for you and when to take it. Be sure to share as much detail as you can about how your migraine attacks start, what symptoms you notice first, and how long they usually last.

3. Try a Combination of Medications

Sometimes, pairing your triptan with another medication can provide better relief. One common option is to combine a triptan with an over-the-counter pain reliever such as acetaminophen or an NSAID like naproxen or ibuprofen. This combination may provide greater pain relief than either medicine on its own.

If nausea makes it hard for you to take pills, anti-nausea medications, such as metoclopramide or prochlorperazine, may help. These medicines can ease nausea and may also help your body absorb the triptan more quickly.

4. Explore Other Options

If you’ve tried several triptans without success, you can ask your healthcare provider about newer or alternative options.

One newer group of medications is called gepants. These drugs block a protein called calcitonin gene-related peptide (CGRP), which plays a key role in migraine pain. Gepants, such as rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy), can be taken during a migraine attack to relieve symptoms. Unlike triptans, they don’t affect blood vessels, so they may be safer for people with heart problems.

Another option is lasmiditan (Reyvow), a medication from a class of drugs called ditans. Like gepants, it treats migraine pain without narrowing blood vessels. However, lasmiditan can cause dizziness or sleepiness, so you may need to avoid driving for a while after taking it.

For more severe or long-lasting attacks, your doctor might recommend dihydroergotamine (DHE), which is available as a nasal spray.

Opioids are rarely used for migraine and only as a last resort. These medications don’t target migraine-specific pathways and can lead to dependence or rebound headaches.

5. Try Preventive Medications

If your migraine attacks are becoming more severe or frequent, preventive approaches can help reduce the burden while lowering your need for triptans. Here are a few strategies to consider for migraine pain:

• CGRP monoclonal antibodies — Anti-CGRP medications interfere with the pain pathways involved in migraine attacks. These drugs are usually given as injections or infusions every one to three months.
• Gepants — Some gepants, such as atogepant (Qulipta) and rimegepant, can be taken regularly to help prevent migraine attacks. (Rimegepant may also be used as needed during an attack.)
• Beta-blockers — Medications such as propranolol help reduce migraine frequency by lowering blood pressure and calming nerve signals. They’re safe to take every day.
• Anti-seizure medications — Also called anticonvulsants, these drugs help prevent migraine by calming overactive nerve cells in the brain.
• Low-dose antidepressants — These medications help reduce the frequency and severity of migraine attacks.
• OnabotulinumtoxinA (Botox) injections — These shots are typically given every 12 weeks to relax nerve endings and help reduce chronic migraine pain.

Ask your healthcare team about other lifestyle changes or tools that may offer more protection. These might include improving sleep habits, staying hydrated, exercising regularly, managing stress, or trying certain supplements.

6. Consult With a Specialist

If you’re still having trouble controlling migraine attacks with triptans, it may be time to see a neurologist — a doctor who specializes in brain and nerve conditions, including migraine. You can ask your primary doctor for a referral or use online resources, such as the American Migraine Foundation, to find a migraine specialist near you.

A specialist can help create a treatment plan tailored to your symptoms, triggers, and lifestyle. They might suggest new migraine treatments, recommend preventive strategies, or order additional testing to better understand your migraine pattern. You don’t have to settle for migraine treatments that aren’t working — with the right support and a few adjustments, better relief is possible.

Talk With Others Who Understand

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

Do you currently take triptans to treat your chronic migraine? What has your migraine treatment journey been like? Share your experience in the comments below, or start a conversation by posting on your Activities page.