Headache Treatments and Medications

Evidence-based approaches to headache treatment

Headache treatment is individualized and diagnosis-driven. Different headache disorders respond to different therapies, and treatment plans often involve a combination of medications, procedures, and non-pharmacologic strategies chosen carefully.

This page outlines the main treatment approaches used in headache care, including acute (attack) treatments, preventive therapies, and specific treatment considerations. The goal is to support informed discussions between patients and clinicians, not to suggest that any single treatment is right for everyone.

Acute (attack) treatments

Acute treatments are used to relieve individual headache attacks once they begin. The choice of acute therapy depends on headache type, attack severity, associated symptoms, medical history, and prior response to treatment.

OHC resources

Migraine acute treatment

CGRP antagonists

Rimegepant (Nurtec®)

Ubrogepant (Ubrelvy®)

Migraine physician prescribing guide

Trusted external resources

Migraine acute treatment tip sheet - from the Canadian Headache Society

Acute migraine medications for adults - from Migraine Canada

Preventive treatments

Preventive treatments are used to reduce headache frequency, severity, and disability over time. They are typically considered when headaches are frequent, prolonged, disabling, or poorly controlled with acute medications alone.

Preventive strategies may include oral medications, injections, or procedures, selected based on diagnosis, comorbidities, pregnancy status, and prior treatment response.

OHC resources

Migraine preventive treatment

Botox ® for migraine

CGRP antagonists

Atogepant (Qulipta®)

Eptinezumab (Vyepti®)

Erenumab (Aimovig®)

Fremanezumab (Ajovy®)

Galcanezumab (Emgality®)

Migraine physician prescribing guide

Trusted external resources

Migraine Preventives Treatment Tip Sheet - from the Canadian Headache Society

Preventive Treatments for Migraine - from Migraine Canada

Botox® for chronic migraine - a patient's guide from Migraine Canada

Pregnancy and breastfeeding considerations

Pregnancy and breastfeeding significantly influence which headache treatments can be used safely. Treatment decisions must balance symptom control with fetal and infant safety, and often differ from non-pregnant care.

This section outlines headache treatment considerations during pregnancy and lactation and highlights therapies that may require avoidance, modification, or specialist input.

OHC resources

Headache in Pregnancy and during Breastfeeding/Lactation

Medication-overuse headache

Medication-overuse headache can develop with frequent use of certain acute headache medications. Recognizing this condition is important, as treatment focuses on adjusting medication use rather than escalating acute therapy.

OHC resources

Medication-overuse headache

Indomethacin trial

Certain headache disorders (i.e., the trigeminal autonomic cephalalgias, or TACs) respond uniquely and dramatically to indomethacin. In these cases, an indomethacin trial can serve both diagnostic and therapeutic purposes when used appropriately and monitored carefully.

OHC resources

Indomethacin trial

Medication handouts

Medication handouts are provided to support shared decision-making, safe use, and informed consent. They outline how medications work, how they are taken, potential side effects, and important precautions.

OHC resources

Medication handouts - an extensive repository of medication handouts intended for both patients and clinicians

Trusted external resources

Patient Resource Kit - comprehensive patient's guide from Migraine Canada

Hot to use acute medications for migraine - a patient's guide from Migraine Canada

Gepants for acute migraine attacks - a patient's guide on from Migraine Canada

Botox® for chronic migraine - a patient's guide from Migraine Canada

How to use preventive medications - a patient's guide from Migraine Canada

Gepants for migraine prevention - a patient's guide on from Migraine Canada

Patients are encouraged to review these handouts and discuss questions with their clinician. 

Looking for condition-specific information or feeling lost?

If you are looking for a more guided, patient-friendly overview, visit the Patients → Headache Disorders section, which walks through common headache conditions in a step-by-step way. 

For explanations of headache disorders and diagnosis, visit Conditions and Diagnosis.

Disclaimer

This material is provided for educational purposes and does not replace independent clinical judgment or institutional protocols. Management decisions remain the responsibility of the treating clinician.