There is no specific treatment for the signs and symptoms of aura, but there are ways to treat migraine pain. Treatments and medications for migraine with aura are similar to treatment for migraine without aura.
Medications used to relieve migraine pain work best when taken at the first sign of an oncoming migraine: for example, as soon as you notice signs and symptoms of a migraine aura beginning.
Types of medications that can be used to treat migraine pain include:
- Pain relievers. Over-the-counter or prescription pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB, others). When taken too long, these may cause medication-overuse headaches, and possibly ulcers and bleeding in the gastrointestinal tract. Migraine relief medications that combine caffeine, aspirin and acetaminophen (Excedrin Migraine) may be helpful, but usually only against mild migraine pain.
- Triptans. Triptan medications (Imitrex, Maxalt, others) are prescription drugs used specifically for migraine because they block the pathways of pain in the brain. They can relieve many symptoms of migraine, and can be taken as pills, shots or nasal sprays. They may not be safe for anyone at risk of a stroke or heart attack.
- Ergots. Ergots (Migergot, Cafergot) are another family of drugs used for migraine. They're most effective when taken shortly after the start of migraine symptoms, and in migraines that tend to last longer than 48 hours. Side effects of ergots can include medication-overuse headaches and worsening of migraine-related vomiting and nausea.
- Opioid medications. For migraine sufferers who can't take triptans or ergots, narcotic opioid medications (especially those that contain codeine) may be helpful. To avoid addiction, these are usually used only if no other treatments are effective.
- Anti-nausea drugs. These can help if your migraine with aura is accompanied by nausea and vomiting. Anti-nausea drugs include chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro). These are usually taken along with other medications.
- Glucocorticoids. A glucocorticoid (prednisone, dexamethasone) is sometimes used along with other medications to provide better pain relief. Because of side effects, glucocorticoids should not be used frequently.
People who have auras that last a long time should not take ergot medications, as they may reduce blood flow to the brain.
Medications can help prevent frequent migraines, with or without aura. Your doctor may recommend preventive medications if you're having frequent, long-lasting or severe headaches that don't respond well to treatment.
After a few weeks of taking them, preventive medications can help you have fewer migraines and help treatments work more effectively when you do have a migraine.
Preventive medication options include:
- Blood pressure-lowering medications. These include beta blockers such as propranolol (Inderal LA, Innopran XL, others), metoprolol tartrate (Lopressor) and timolol (Betimol). Calcium channel blockers such as verapamil (Calan, Verelan, others) can be helpful in preventing migraines with aura.
- Antidepressants. Amitriptyline, a tricyclic antidepressant, has been found effective in preventing migraines. Because of the side effects of amitriptyline (such as sleepiness, weight gain and more), sometimes other antidepressants are prescribed.
- Anti-seizure drugs. Valproate (Depacon) and topiramate (Topamax) may help you have less frequent migraines, but may cause side effects such as dizziness, weight changes, nausea and more.
- Botox injections. Injections of onabotulinumtoxinA (Botox) about every 12 weeks can help prevent migraines in some adults.
Stress management and lifestyle
You may be able to soothe migraine with aura pain with the self-care techniques that can be used for migraine without aura:
- Cognitive behavioral therapy (CBT). This technique teaches you more-appropriate ways to deal with stressful situations, and may help reduce the number of migraines you have. CBT may be combined with another strategy called learn to cope (LTC). LTC involves slowly exposing you to common headache triggers to help you become less sensitive to them.
- Get a healthy amount of sleep. Don't sleep too much or too little. Set a consistent sleep and wake schedule that you follow each day and night.
- Relax when symptoms start. When migraine aura symptoms start, head to a quiet, dark room and rest with an ice pack (wrapped in a towel or cloth) placed at the back of your neck.