Migraine treatment options explained: acute and preventive medications
Learn the difference between acute and preventive migraine treatments and how they help manage migraine
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Key takeaways
Understanding the difference between acute and preventive migraine treatment can help you become more informed and advocate for your migraine care.
- Acute treatments may relieve symptoms, such as head pain, sensitivity to light and sound, and nausea, when taken during a migraine attack
- Preventive treatments may reduce migraine attack frequency, duration, or severity
- Acute treatments are taken as needed, while preventive treatments are taken regularly regardless if a migraine attack is occurring
- Talking with your doctor is essential to find the right migraine treatment plan for you
When it comes to migraine management, there are two primary forms of treatment, acute and preventive medications, in addition to lifestyle changes. Understanding the difference between these two treatments can help you when talking to a doctor about possible migraine treatment plans.
Here’s a quick guide to help you have a more informed conversation about migraine treatments with your doctor.
Acute treatments (also called “abortive treatments”) primarily manage the headache stage of a migraine attack.
What is acute migraine treatment?
Acute treatments (also called “abortive treatments”) are used when a migraine attack begins to stop the migraine attack, reduce headache pain, and relieve the symptoms. The American Headache Society has outlined several goals of acute treatment, including:
- Rapid and consistent freedom from pain and associated symptoms especially the most bothersome symptom, without recurrence
- Restored ability to function
- Minimal need for repeat dosing or rescue medications
Key Points: Acute treatments are taken during a migraine attack. This means you don’t have to take them regularly or remember to take medicine on a schedule. Acute treatment helps reduce migraine symptoms such as head pain, sensitivity to light/sound, and nausea, that can take time away from your everyday activities.
Considerations: While acute treatments provide immediate relief during migraine attacks, preventive therapies reduce frequency and severity of migraine attacks.
Using some acute treatments, such as over-the-counter or prescription pain relievers, too often may also lead to medication overuse headache (MOH), a condition where frequent use of acute medications can actually increase headache frequency.
Like any medication, acute migraine treatments come with potential side effects. Additionally, some people find that acute treatments work better when taken early in a migraine attack.
What is preventive migraine treatment?
Preventive treatments are taken regularly—even when you're not actively experiencing migraine attacks—to reduce the frequency, severity, and/or duration of migraine attacks.
This treatment is usually considered for people who experience migraine attacks more frequently, or for those whose migraine creates a substantial, negative impact on their daily activities despite acute treatment.
The American Headache Society has outlined several goals of preventive treatment, including:
- Reduce attack frequency, severity, duration, and disability
- Improve responsiveness to and avoid escalation in use of acute treatment
- Improve function and reduce disability
Key Points: If a preventive treatment is right for you, it may reduce the number of migraine days you have each month, which means you spend less time feeling unwell and more time enjoying activities you love. With fewer or less severe migraine attacks, your daily routine is less likely to be thrown off.
Considerations: Preventive options require consistent use to be effective, and like any medication, acute migraine treatments come with potential side effects.
You will need to commit to a management plan that a doctor will monitor and adjust as needed. It may also take a minimum of eight weeks for these treatments to start working, so patience is important.
Test your knowledge
When is acute migraine treatment used?
Correct
Yes, it can reduce frequency and severity
Not quite
Correct answer: When a migraine attack begins
Acute vs preventive treatment: key differences
To summarize, below is a snapshot of the key differences between acute migraine treatment and preventive migraine treatment.
Acute treatment
- When to take it: As needed and prescribed, as soon as you experience migraine symptoms
- Goal of treatment: Relief of pain and associated symptoms from migraine attack
- Speed of relief (if treatment works): Within two hours
Preventive treatment
- When to take it: Consistent use, taken regularly as prescribed
- Goal of treatment: Reduce frequency, severity, and/or duration of migraine attacks
- Reduction in frequency of migraine attacks (if treatment works): May take a few months before a reduction in migraine days per month is observed
Which type of treatment option is right for you?
Choosing a treatment depends on how often you experience migraine attacks, how long they last, how severe they are, and how much they affect your life. If you do not experience migraine symptoms often, acute treatment alone may be enough. If your migraine symptoms are more frequent, disabling, or resistant to acute care, a preventive strategy should be considered.
Your healthcare provider will determine the appropriate migraine treatment plan by considering how often you experience migraine attacks, how long they last, how severe they are, and how much they affect your life.
Always talk to your doctor to find a treatment plan that fits your preferences, lifestyle, and medical history.
Understanding migraine treatment options matters
Some people who live with migraine may think they need to push through the pain, or may not know about available treatment options. Understanding the roles of acute and preventive treatments for migraine can help you become an informed and active participant in improving your health and quality of life.
If you think you may be experiencing migraine—or if your current treatment isn’t working the way you need it to—talk to a doctor. Understanding the differences between migraine treatment types can help you have a more confident, productive conversation.
Learn more about migraine: www.pfizerforall.com/migraine.
References
Ailani J, Burch RC, Robbins MS, the Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039. https://doi.org/10.1111/head.14153
Commonly used acute migraine treatments. American Migraine Foundation. March 27, 2025. Accessed April 10, 2025. https://americanmigrainefoundation.org/resource-library/acute-migraine-treatments/.
Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol. 2021;17(8):501-514. https://doi.org/10.1038/s41582-021-00509-5
Fischer MA, Jan A. Medication-overuse headache. In: StatPearls. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK538150
Jenkins B. Migraine management. Aust Prescr. 2020;43(5):148-151. doi:10.18773/austprescr.2020.047
Migraine prevention 101: What it is, when to use it and why. American Migraine Foundation. May 8, 2023. Accessed April 10, 2025. https://americanmigrainefoundation.org/resource-library/migraine-prevention-101.
Pescador Ruschel MA, De Jesus O. Migraine headache. In: StatPearls. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK560787