Your Guide to Telehealth for Migraine

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7 Signs Your Migraine Treatment Isn't Working

  • Male doctor sitting with female patient by window, side view
    Is there a better migraine treatment out there for you?
    Migraines aren’t your typical headaches. The severe head pain, nausea, vomiting, and sensitivity to light and sound can last for hours, or even days. If you’ve ever been in the throes of a migraine, you know how desperate you can feel for the symptoms to subside. Unfortunately, there isn’t one universal treatment to help all migraine sufferers. But if you can recognize signs your current migraine treatment is not working as well as it should, you can be proactive in finding one that brings you the relief you deserve.

  • woman sitting at table with headache
    1. You aren’t getting the same migraine relief as you used to.
    You may have been lucky and hit the “treatment jackpot” earlier on and found a migraine medication that worked great. As time went on though, you might have noticed the same med just isn’t helping like it did before. While this can be frustrating, you aren’t alone. Researchers don’t know exactly why, but it’s not uncommon to have a migraine treatment stop working. Sometimes simply trying a different medication within the same class can make a difference, such as changing from sumatriptan (Imitrex) to another med in the triptan family like zolmitriptan (Zomig). Or you may need to switch to a different form of migraine treatment altogether. Ask your doctor what other options are available.

  • senior woman with head in hands
    2. You’re getting more than 4 migraines a month.
    If your treatment only consists of pain-relieving medication and you are experiencing several migraines each month, you may be a good candidate for migraine preventative medication as well. This type of treatment can help reduce the frequency and severity of your migraines. Many medications used for migraine prevention have other medical uses as well. Some common examples include: propranolol (Inderal), a beta-blocker used to treat high blood pressure, amitriptyline (Elavil), an anti-depressant that affects serotonin and other brain chemicals, and topiramate (Trokendi), a drug originally developed to stop seizures. Erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) are new drugs, called CGRP blockers, that were specifically developed to prevent migraines. Preventative migraine medications need to be taken regularly, not just when symptoms start, and may require several weeks before an effect is seen.

  • man looking at medication in front of medicine cabinet
    3. You’re reaching for your migraine medication almost daily.
    Contrary to what it may seem, taking migraine medication too frequently may actually make your headaches worse. A phenomenon known as “rebound headaches” or “medication-overuse headaches” affects many people who suffer from migraines, leading to shorter and shorter periods of pain relief. Make sure to let your doctor know if you are taking your medication more than 10 days each month. You may be advised to cut back on your medication, and in time, you should experience improvement.

  • Woman Working With a Sore Neck
    4. You still get migraines around the time of your period.
    Hormones, particularly estrogen, can play a role in the development of migraines. If you are someone whose migraines tend to occur right before or during your period, it may be due to your body’s drop in estrogen during that time. Some treatments may be more effective for treating this type of migraine, so be sure to talk to your doctor.  Some studies show that taking certain triptans, one of the most common classes of pain-relieving migraine medication, twice daily during your period can help with menstrual migraines. Other women have found success with taking magnesium or birth control pills.

  • glasses of red and white wine on table
    5. You’ve never tried to recognize your migraine triggers.
    Migraine treatment is more than simply taking medication. Many people can identify specific things that cause their migraines to develop. If haven’t done this, now is the time! Try keeping a headache log. Pay attention to things like sleep, stress, food and alcohol intake, and other medications. You may be able to link certain things in your life to your migraines. Once you learn to avoid these triggers, you’ll likely notice an improvement in your migraines.

  • Young woman sitting on the couch with stomach upset
    6. Nothing you do can get rid of your nausea during a migraine.
    Focusing simply on pain management may not always be enough for migraine relief. The nausea that accompanies many migraines can be quite debilitating. If this sounds like you, an anti-nausea medication may need to be added to your treatment regime. Ondansetron (Zofran) and metoclopramide (Reglan) are two that are commonly used. Natural remedies like ginger and peppermint have also been shown to help with nausea.

  • Smiling Woman
    7. You don’t want to be so reliant on medication.
    Many people don’t like the idea of simply popping a pill every time a migraine comes on. Ask your doctor if you are interested in learning more about complementary therapies. Some patients find acupuncture, placing thin needles into specific points in the skin, helps with pain relief. Relaxation techniques, such as biofeedback where you learn how to slow down your body’s physical responses like heart rate and blood pressure, may also relieve tension and improve migraines.

7 Signs Your Migraine Treatment Isn't Working

About The Author

Erin Azuse, RN, has been a registered nurse for 18 years, working in neonatal intensive care and pediatrics. She specializes in creating educational materials for patients, consumers, and other healthcare providers, as well as content marketing for private physicians’ practices, medical device companies, and nursing schools.
  1. Headache: Hope Through Research. National Institute of Neurological Disorders and Stroke.
  2. Menstrual Migraine. American Headache Society.
  3. Migraine. Mayo Clinic.
  4. Patient Education: Migraine Headaches in Adults (Beyond the Basics). UpToDate.
  5. The Role of Adherence and Triggers in Headache Management. American Migraine Foundation.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jul 26
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.