“The biggest thing people should do is be cautious of opioid and barbiturates. They don’t necessarily help a great deal with migraine headaches because they don’t treat the cause like other migraine treatments do,” says Dr. Lloyd Kapp, medical director with BlueCross BlueShield of South Carolina.  

There are a few reasons to consider other options before taking these drugs. Overusing these drugs can make headaches worse, they may not be as effective as other prescriptions, and they have risks. 

Opioids have high rates of misuse. These drugs can cause serious withdrawal symptoms when a person stops taking them. Most doctors recommend using opioids and other pain medications sparingly. 

Before taking an opioid or a barbiturate for migraine, start with over-the-counter medications that contain aspirin or acetaminophen and caffeine. Other options to treat migraine include nonsteroidal anti-inflammatory drugs, like ibuprofen or naproxen. 

“Starting with over-the-counter medications is a good first step for treating migraine. If those medications do not help, people should talk with their doctors about recommendations,” Kapp says. 

If migraine headaches are more severe or these medications do not help, the AAN recommends other prescription medications. Patients should consult with their doctors to determine the best medications based on an individual’s history and needs. 

“It is worth discussing with your doctor because everybody is a little different. Sometimes doctors can pinpoint causes of migraine and treat those. That will be much more effective in preventing migraine headaches from coming on in the future,” Kapp says. 

In general, patients should have an open dialogue with a doctor or health care provider for any treatment or test. Do the research and know what doctors recommend. You can find resources on Choosing Wisely to help you know what questions to ask. 

*The AAN and the American Board of Internal Medicine (ABIM) are independent organizations that offer health information you may find helpful.