Migraines are far more than just a bad headache. For the estimated 15% of Irish adults who experience migraines, these debilitating neurological episodes can significantly impact work, family life, and overall wellbeing. If you have been suffering in silence or finding that over-the-counter painkillers no longer provide relief, it may be time to explore more effective treatment options.
This comprehensive guide covers everything you need to know about migraine treatment in Ireland, from understanding your symptoms to accessing prescription medications like triptans through online GP consultations.
One of the most common misconceptions is that a migraine is simply a severe headache. While headache is often a prominent feature, migraines are actually a complex neurological condition with distinct characteristics.
Tension headaches are the most common type of headache and typically present as:
Migraines have a distinct pattern that sets them apart:
If you experience at least two of these features during your headaches, you are likely experiencing migraines:
Plus at least one of these:
Migraines typically progress through four stages, though not everyone experiences all of them.
Hours or even a day before the headache begins, you may notice subtle warning signs:
Recognising your prodrome symptoms can help you prepare for an attack and take medication early for better effectiveness.
Aura typically develops over 5-20 minutes and lasts less than 60 minutes. It usually precedes the headache phase, though some people experience aura without headache.
Visual aura is most common and may include:
Sensory aura may involve:
Motor aura (less common):
If you experience aura symptoms for the first time, especially if they last longer than an hour or involve weakness, seek medical attention to rule out other conditions.
The main attack typically includes:
Without treatment, this phase can last anywhere from 4 to 72 hours.
After the headache resolves, many people experience a postdrome or migraine hangover:
This phase can last for several hours to a day.
Understanding and avoiding your personal triggers is a crucial part of migraine management. While triggers vary between individuals, common ones include:
Stress is the most commonly reported migraine trigger, affecting up to 70% of sufferers. Interestingly, migraines often occur during the let-down period after stress (such as weekends or holidays) rather than during the stressful event itself.
Changes to your sleep pattern can trigger migraines:
Hormonal fluctuations are a significant trigger for many women:
Certain foods and beverages can trigger migraines in some people:
For mild to moderate migraines, over-the-counter (OTC) medications can be effective, especially when taken early in an attack.
How it works: Paracetamol reduces pain by acting on the central nervous system. Its exact mechanism in migraine is not fully understood.
Dosage: 1000mg (two 500mg tablets) at the onset of migraine. Can be repeated every 4-6 hours if needed, with a maximum of 4000mg in 24 hours.
Effectiveness: Works best for mild migraines when taken early. Less effective for moderate to severe attacks.
Advantages:
Considerations:
How it works: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking prostaglandin production.
Dosage: 400-600mg at the onset of migraine. Can be repeated every 4-6 hours if needed, with a maximum of 1200mg in 24 hours (OTC limit).
Effectiveness: More effective than paracetamol for many migraine sufferers. Works best when taken early.
Advantages:
Considerations:
How it works: Aspirin is an NSAID with anti-inflammatory, analgesic, and antiplatelet properties.
Dosage: 900-1000mg at the onset of migraine, dissolved in water for faster absorption.
Effectiveness: High-dose soluble aspirin is one of the most effective OTC options for migraine, comparable to lower-dose triptans in some studies.
Advantages:
Considerations:
Several OTC products combine painkillers with other ingredients:
Solpadeine (Ireland):
Migraleve:
Anadin Extra:
Using OTC painkillers too frequently can paradoxically cause more headaches. If you find yourself using acute migraine medication on 10 or more days per month, you are at risk of developing medication overuse headache (MOH).
Signs of MOH include:
If you suspect MOH, consult a GP. Breaking the cycle typically requires stopping the overused medication under medical supervision.
When OTC medications are not providing adequate relief, prescription treatments can make a significant difference. The most effective prescription medications for acute migraine are the triptans.
Triptans are a class of medications specifically designed for migraine. They work differently from simple painkillers and target the underlying mechanisms of migraine.
How triptans work:
Triptans are most effective when taken early in an attack, ideally during the headache phase (not during aura). They do not prevent migraines but treat them once they start.
Sumatriptan was the first triptan developed and remains the most commonly prescribed.
Available forms:
Dosage: Start with 50mg or 100mg tablet. If the first dose does not work, do not take a second dose for the same attack. If the headache returns after initial relief, a second dose can be taken after 2 hours. Maximum 300mg in 24 hours.
Onset: Tablets work within 30-60 minutes; nasal spray within 15-30 minutes.
Effectiveness: Approximately 60-70% of people experience significant relief within 2 hours.
Rizatriptan is known for fast onset, making it suitable for rapidly developing migraines.
Available forms:
Dosage: 10mg at onset (5mg if taking propranolol). Second dose after 2 hours if needed. Maximum 20mg in 24 hours.
Onset: Works within 30-45 minutes; orodispersible form may be slightly faster.
Advantages: Fast-acting; orodispersible form is convenient when nausea makes swallowing difficult.
Zolmitriptan offers both oral and nasal spray options.
Available forms:
Dosage: 2.5mg at onset, can increase to 5mg if needed. Second dose after 2 hours if needed. Maximum 10mg in 24 hours.
Onset: Tablets work within 45-60 minutes; nasal spray within 15 minutes.
Several other triptans are available in Ireland:
Common side effects (usually mild and short-lived):
Important: Triptans are not suitable for everyone. They should not be used if you have:
Always discuss your full medical history before starting a triptan.
Nausea and vomiting are common during migraines. Anti-emetics can help and may also improve absorption of other migraine medications.
Metoclopramide (Maxolon):
Domperidone (Motilium):
Prochlorperazine (Stemetil):
If you experience frequent migraines (4 or more per month) or your attacks are particularly severe, your GP may recommend daily preventive medication.
Propranolol (Beta-blocker):
Topiramate (Anti-epileptic):
Amitriptyline (Tricyclic antidepressant):
Candesartan (Blood pressure medication):
Your GP will help you choose the most appropriate preventive based on your medical history, other health conditions, and lifestyle factors.
Many people with migraines manage their condition with OTC medications and never consult a doctor. However, you should see a GP if:
Frequent migraines may benefit from preventive treatment, which can significantly reduce attack frequency and severity.
If standard painkillers are not helping, prescription treatments like triptans may provide much better relief.
Seek medical advice promptly if you experience:
These symptoms may indicate a different type of headache or another medical condition that requires investigation.
Consider consulting a GP if migraines are:
Online GP consultations have made accessing migraine treatment easier and more convenient than ever. Here is how the process works with GetYourGP.
Visit our [migraine treatment service](/services/migraine-treatment) page or [book a consultation](/consultations) directly. Same-day appointments are often available.
Before your consultation, you will provide information about:
Connect with an Irish-registered GP who will:
If appropriate, the GP will issue a prescription for:
The prescription is sent electronically to your chosen pharmacy for same-day collection.
While medications are important, lifestyle modifications can significantly reduce migraine frequency and severity.
Track your attacks to identify patterns and triggers:
After several months, you may identify your personal trigger patterns.
Dehydration is a common migraine trigger:
Since stress is the most common trigger:
Regular moderate exercise can reduce migraine frequency:
There is currently no cure for migraines, but they can be effectively managed. Many people find that their migraines improve with age, and some women experience significant improvement after menopause.
No, triptans are not addictive. However, using them too frequently (more than 10 days per month) can lead to medication overuse headache.
Yes, you can combine a triptan with paracetamol or an NSAID. Some people find this combination more effective than either alone.
Most triptans provide relief within 30-60 minutes when taken as tablets. Nasal sprays work faster (15-30 minutes), and injections are fastest (within 10-15 minutes).
If one triptan is not effective, another may work better. The triptans have slightly different properties, and people respond differently to each one. Do not give up after trying only one.
Changes in cabin pressure can trigger migraines. If you are prone to migraines, consider taking preventive medication before flying and have acute treatment readily available.
Yes, there is a strong genetic component to migraines. If one parent has migraines, there is approximately a 50% chance their children will too. If both parents have migraines, the risk increases to about 75%.
Yes, migraines can occur at any age, including childhood. In children, migraines may present differently, with shorter duration and more abdominal symptoms.
Living with migraines can be challenging, but effective treatment is available. If OTC medications are not providing adequate relief, prescription treatments like triptans can make a significant difference to your quality of life.
Do not continue to suffer in silence. [Book a consultation](/consultations) with one of our Irish-registered GPs today and take the first step toward better migraine management. Whether you need acute treatment like triptans or want to discuss preventive options, we are here to help.
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*This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional before starting any new medication. If you experience sudden severe headache, headache with fever and stiff neck, or any concerning neurological symptoms, seek emergency medical care immediately.*
General Practitioner
Dr. Fasi Ullah is a registered General Practitioner with the Irish Medical Council, providing expert healthcare advice to patients across Ireland through GetYourGP.
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