Anyone living with migraine understands the challenge of making it through the day with intense headaches. There are many different treatment options that may help you get some relief, but what if a treatment isn’t the right one for you? If a medication isn’t working well or is causing other problems, you may need to try a different treatment.

Unlike a normal headache, migraine headaches stem from a neurological problem and often cause throbbing pain on one side of the head and other distressing symptoms. There are different treatments that can help you manage the symptoms of migraine — some are acute treatments, while others are preventive treatments. Acute migraine treatments are medications that decrease the severity of headaches and other neurological symptoms during a migraine attack, making it easier for you to function. On the other hand, preventive medications help stop migraine attacks from happening in the first place.

While both acute and preventive treatments can help with migraine symptoms, some treatments may not help you as much as others. If you’re currently taking medication for migraine, this article will review signs that may mean it’s time to switch to a different treatment. While one treatment may not work out, know that you have options. Your neurologist (neurological disorder specialist) or another member of your healthcare team can help you decide which alternative treatments may be a better fit for you.

Here are five signs it might be time to switch migraine treatments.

1. Your Symptoms Don’t Improve

After getting a migraine diagnosis, your primary care or neurology provider will use their expertise and guidance from the American Headache Society to inform your treatment plan. They’ll likely have you start with first-line treatments — including therapies that block calcitonin gene-related peptide (CGRP) to reduce pain and inflammation — to see if they help your symptoms. If your migraine attacks aren’t too intense or frequent, your doctor may recommend over-the-counter (OTC) medications. OTC medications like nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen sodium (Aleve) or ibuprofen (Motrin), or a combination of aspirin, acetaminophen, and caffeine (Excedrin Migraine) may offer migraine relief. For more severe migraine headaches, your doctor may prescribe migraine-specific medications and pain relievers like triptans.

How well a treatment works depends on your type of migraine, specific migraine symptoms, and overall health.

Unfortunately, not every migraine treatment works for everyone. How well a treatment works depends on your type of migraine, specific migraine symptoms, and overall health. With first-line treatments, you may find that your headaches and other migraine symptoms don’t get much better. For example, if you’ve been prescribed sumatriptan, you may find that your migraine attacks do not respond as well as you hope. If this happens, your doctor may recommend trying a different treatment for better results.

The National Headache Foundation recommends keeping a headache diary to track headaches. Keeping a diary may be helpful for identifying headache triggers as well as signs a migraine treatment isn’t working.

Switching to a new migraine treatment can help improve symptoms for many people, including members of MyMigraineTeam. As one team member shared, “I was on a drug for 17 months when it first came out. It never helped. … When my 18th dose was due, I started a different drug … it took my chronic migraine attacks of 25 a month down to just a few a month.”

Another team member described their experience with migraine injections: “I tried the medication for a year. Didn’t help at all. I’ve been on a new drug for the past year. I haven’t had a migraine attack since I’ve used it.”

You don’t need to stick with a treatment that isn’t bringing you relief. If you feel like a treatment isn’t working, talk to your doctor about switching to a different medication.

2. You Stop Responding to Treatment

Perhaps you already take medication for migraine and it helps your symptoms. However, even if you respond well to a drug at first, there’s still a possibility that you’ll stop responding after a period of time and your symptoms will come back. If this happens, switching to a different medication may help.

A MyMigraineTeam member who had been on one migraine medication said, “It helped at first, but toward the end, the migraine attacks came back.”

Another person who’d taken the same drug added, “After two years, it stopped working for me. Now I’m on Nurtec every other day.”

If you notice that your migraine medication isn’t working as well as it did before, reach out to your healthcare provider. They can suggest a different treatment that may be more effective for you.

3. You Have Trouble Affording Treatment

The cost of treatment is a major concern for many people living with migraine. Medications are expensive, and many people rely on insurance coverage to afford treatments. However, your insurance may offer varying levels of coverage across treatments. If your health insurance plan changes and your current treatment becomes too expensive, you may consider starting a different treatment that’s more affordable.

The migraine drugs market has grown due to advances in medications, like CGRP inhibitors, and increased awareness of migraines. However, the high cost of treatments, with average prices reaching between $200 and $300 per prescription, remains a significant challenge.

Some MyMigraineTeam members have mentioned a lack of insurance coverage as a reason for switching treatments. “I’ve been on medication for 14 months. It works well for me … but I just got a letter from my insurance that they won’t cover it anymore and want me to switch to a different drug,” one MyMigraineTeam member said.

Another shared, “My insurance wouldn’t pay for one migraine treatment, but they would pay for a different one.”

If changes to your health insurance make your current medication too expensive, your healthcare provider can discuss other treatment options with you. They may suggest a different treatment plan that’s more affordable and will still offer relief from your migraine symptoms.

4. You Experience Difficult Side Effects

Side effects are a reality with most drugs, including migraine medications. While some side effects are minor, others can make it difficult to keep taking a drug. One major concern for people taking migraine medications is the risk of medication overuse headaches (MOH), also known as rebound headaches. MOH can occur if you take a headache medication too frequently and it causes more headaches. Both OTC and prescription medications for migraine can lead to MOH if taken too often.

For some people, certain side effects are unbearable and can make them want to change medications. One MyMigraineTeam member shared their experience: “I took migraine medication for a year, but I switched to a different one because I had too many side effects. I was on the latter drug for two years. It worked much better for me.”

“I’ve been on a new drug for the past year. I haven’t had a migraine attack since I’ve used it.”

— A MyMigraineTeam member

Some side effects can be resolved by changing the way you take medication. For example, people who don’t respond well to drugs swallowed as pills might switch to a medication administered as a nasal spray. As one team member reported, “Nasal spray works best for me because my stomach goes nuts. …The pills don’t absorb well.”

If your migraine medication causes side effects that are too difficult to live with, talk to your healthcare provider about trying a different treatment. They can review the possible side effects of new treatments. Importantly, some medications used to treat migraine can cause more severe side effects, such as heart attack or damage to the intestines. If you experience any sudden symptoms of major health events, stop using the drug and seek medical attention immediately.

5. You Have Specific Treatment Preferences or Risk Factors

Your healthcare provider should take your preferences into account when determining your migraine treatment plan. If your current medication doesn’t align with your treatment goals, you may want to try a different one.

Some people change treatments because they don’t want to — or can’t — take certain drugs. Perhaps you have other health conditions or allergies that make it unsafe to take some types of medications. One MyMigraineTeam member switched treatments due to health concerns: “I was taken off my previous medication because it increased my risk of another health condition. Since then, I’m experiencing daily, severe migraines. … I’m now using a migraine device.”

If your migraine medication causes side effects that are too difficult to live with, talk to your provider about trying a different treatment.

Other people may want to avoid migraine medications altogether. If this is the case for you, ask your doctor about neuromodulation devices (tools that adjust brain signals) that treat migraine pain. These devices can help provide relief by changing how your brain receives pain signals.

Your neurology provider may also suggest lifestyle changes, such as increasing physical activity, as recommended by the American Migraine Foundation. By taking active steps to avoid migraine triggers, you can work to reduce migraine attacks and live a healthier, more fulfilling life.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine. More than 84,000 members come together to ask questions, give advice, and share their experiences with others who understand life with migraine.

Have you had to switch treatments for migraine? What was your experience like? What advice would you offer others? Share your experience in the comments below or on your Activities page.