Migraine — treatment vs prevention
Reviewed by the My London Pharmacy clinical team, Zeenah Araim, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Migraine is more than a headache, often bringing throbbing pain, nausea and sensitivity to light or sound. Treatment falls into two parts: relieving an attack when it happens, and, for frequent migraines, preventing them. A clinician can help you find the right balance and discuss acute treatments such as triptans after a consultation.
What migraine is
Migraine is a neurological condition, not simply a bad headache. Attacks often involve a moderate to severe throbbing or pulsing pain, usually on one side of the head, along with nausea and sensitivity to light, sound or smells. An attack can last anywhere from a few hours to a few days, and many people need to rest in a quiet, dark room until it passes. Between attacks, most people feel completely well, which is part of what sets migraine apart from other kinds of ongoing headache.
Many attacks move through recognisable phases, although not everyone experiences all of them. In the hours or day beforehand there may be a prodrome, with subtle changes in mood, energy, appetite or concentration. Some people then have an aura, such as visual disturbances, flashing lights, blind spots or tingling in the face or hands, which usually lasts less than an hour. The headache phase follows, and afterwards a postdrome, sometimes described as a migraine hangover, can leave you feeling drained for a day or so. Learning to recognise your own pattern of symptoms, phases and triggers is one of the most useful parts of managing migraine well.
Treatment versus prevention
Managing migraine involves two distinct goals. Acute, or rescue, treatment aims to stop or ease an attack once it has started. Preventive treatment aims to reduce how often attacks happen and how severe they are when they do.
Most people begin with acute treatment alone, using it as and when an attack occurs. Prevention is usually considered when attacks are frequent, long-lasting or significantly affecting daily life, work or study. The two approaches work together rather than replacing each other, and a clinician can help you decide which you need and when to introduce prevention. Thinking of your migraines in these two parts often makes a plan feel clearer and more manageable.
Treating an attack
For a migraine attack, early treatment tends to work best. Simple pain relief such as paracetamol or ibuprofen, taken as soon as symptoms begin, helps some people, particularly with milder attacks. Taking it early, before the pain becomes established, gives the best chance of success, and a soluble form can act more quickly. If nausea makes tablets hard to keep down, an anti-sickness medicine is sometimes added, which can also help the body absorb pain relief.
When ordinary painkillers are not enough, a clinician may consider a triptan, a group of medicines developed specifically for migraine. Options a clinician might discuss include Sumatriptan Tablets, Rizatriptan 10mg Tablets and Zolmitriptan Tablets, while orodispersible forms such as Maxalt Melt 10mg Wafers dissolve on the tongue and can be easier to take when nausea is present. Frovatriptan 2.5mg Tablets is a longer-acting option that some people are prescribed. Triptans work by acting on the changes in the brain and its blood vessels that occur during an attack, and they are usually taken at the onset of the headache rather than during any aura. If one triptan does not suit you, a clinician can suggest trying another, as people respond differently. To reduce the risk of medication-overuse headache, triptans and other acute treatments are generally limited to a set number of days each month.
Preventing frequent migraines
If you have frequent or disabling migraines, prevention may be discussed. Preventive treatment is taken regularly rather than only during an attack, with the aim of reducing how often attacks occur over time and making them easier to manage when they do happen. It is usually considered when attacks are frequent, long-lasting, or not well controlled by acute treatment alone.
Several types of preventive medicine exist, and some were originally developed for other conditions before being found to help migraine. The choice depends on your health, any other conditions and how migraine affects you, and it is something a clinician weighs up with you. Prevention often takes several weeks to show its full benefit, so patience and regular review are important, and it is worth giving any preventive plan a fair trial at an adequate dose before judging whether it works. NICE guidance supports reviewing preventive treatment periodically, including considering a trial without it once migraines have been well controlled for a time. Keeping a headache diary during this period helps you and your clinician see whether attacks are becoming less frequent.
Types of migraine
Migraine can take more than one form, and recognising which you experience helps guide treatment. The most common types are migraine with aura, where warning symptoms such as visual disturbances appear before the headache, and migraine without aura, where the headache begins without these warning signs.
Some people have attacks only occasionally, while others experience them frequently enough to be described as chronic migraine, meaning headaches on many days of the month. The pattern and frequency of your attacks are an important part of deciding whether acute treatment alone is enough or whether prevention should be considered, which is something a clinician can help you work through.
Identifying and managing triggers
Many people find certain factors make migraines more likely. Common triggers include stress, poor or irregular sleep, missed meals, dehydration, certain foods and drinks, bright or flickering light, and hormonal changes. Keeping a simple diary of attacks, noting what happened beforehand, can help reveal your own patterns, though it is worth knowing that triggers often add up rather than acting alone, so an attack may follow a combination of factors rather than any single one.
Once triggers are recognised, steady routines around sleep, meals and hydration can reduce how often attacks happen. It is also worth being aware that taking pain relief very frequently can, over time, lead to medication-overuse headache, where the treatment itself contributes to more headaches. A clinician can help you avoid this by reviewing how often you use acute treatment.
Migraine and hormonal changes
Some people notice that migraines follow a hormonal pattern, with attacks clustering around the time of their period, when natural oestrogen levels fall. These attacks can be more intense or longer-lasting than others and sometimes respond less readily to standard acute treatment. Recognising this pattern through a diary can open up more tailored approaches, which a clinician can talk through with you.
Hormonal factors are also relevant when considering contraception, as the type of migraine you have, particularly whether you experience aura, can influence which options are suitable. This is a conversation worth having with a clinician rather than navigating alone, so that migraine management and any contraceptive choices fit together safely.
Everyday habits that support fewer attacks
Alongside medicines, steady daily routines can make a real difference to how often migraines strike. Regular sleep, with consistent bed and waking times even at weekends, staying well hydrated, and eating at regular intervals all help smooth out the dips and spikes that can set off an attack. Managing stress, taking breaks from screens, and building in some regular gentle activity are also worth attention, as both too much and too little of certain things can act as triggers.
There is no single certain way to stop migraines, but together these habits create a more stable foundation that can lower how often attacks happen and support whatever treatment you are using. Small, sustainable changes tend to work better than sweeping ones, and a clinician or pharmacist can help you focus on the areas most likely to help you.
When to seek medical advice
Speak to a clinician if migraines are frequent, are not well controlled by your current treatment, or are affecting your work, study or daily life. It is also worth seeking advice if you are relying on pain relief more than a couple of days a week, or if your usual pattern of attacks changes.
Seek urgent help, or call 999, for a sudden, severe headache unlike any before, a headache with a stiff neck, fever, confusion, weakness, difficulty speaking or a change in vision, as these need immediate assessment. While migraine itself is not dangerous, these features can point to something that needs prompt attention.
Frequently asked questions
What is the difference between treating and preventing migraine?
Acute treatment aims to stop or ease an attack once it starts, while preventive treatment is taken regularly to reduce how often attacks happen. Many people use acute treatment alone, adding prevention if attacks are frequent.
What are triptans?
Triptans are a group of medicines developed specifically for migraine attacks. They act on the changes in the brain that occur during an attack and are considered when ordinary painkillers are not enough.
When should I take migraine treatment?
Acute treatment usually works best when taken early, as soon as an attack begins. A clinician can advise on the right timing and treatment for your migraines.
Can taking painkillers too often make migraines worse?
Yes. Using pain relief very frequently can lead to medication-overuse headache. If you are taking painkillers more than a couple of days a week, speak to a clinician.
Why do my migraines come around my period?
Some people experience migraines linked to the fall in oestrogen around their period. Keeping a diary can reveal the pattern, and a clinician can discuss tailored approaches and any contraception considerations.
When is a headache an emergency?
Get urgent help for a sudden, severe headache unlike any before, or one with a stiff neck, fever, confusion, weakness, difficulty speaking or changes in vision.