Migraine attacks vary from person to person. Not everyone has the same migraine symptoms or triggers. How long a migraine attack lasts can vary, too. According to the National Headache Foundation, many migraine attacks last 4 to 72 hours.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293c44783a-c403-4cc9-8425-9cd1e8dc4571 “But some people have migraines for a shorter time, and some people have them for longer. It’s very individual,” says Alexander Mauskop, MD , a neurologist and the founder and director of the New York Headache Center in New York City. Several factors can play a role in how long a migraine attack lasts, from how many triggers occur before the attack to how you respond once an attack begins. Here’s what you should know about the duration and phases of migraine attacks and how certain self-care interventions and drugs may shorten an attack.
Status Migrainosus Status Migrainosus A debilitating migraine attack that lasts longer than 72 hours (3 days) and doesn’t respond to normal treatment is called status migrainosus, or intractable migraine. It can be more medically serious than a normal migraine attack, especially with prolonged symptoms, such as vomiting, which can cause severe dehydration . Status migrainosus is what brings many people to a hospital’s emergency department, where healthcare providers can administer a variety of IV drugs to break the pain cycle.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ea2a9ec0-f5d9-4d0e-8a9f-9ddef2b4796d
The Takeaway Migraine attacks typically last 4 to 72 hours but can vary widely, with symptoms unfolding across multiple phases, including prodrome, aura, headache, and recovery. Early treatment and self-care strategies, including hydration, rest, and trigger avoidance, can help shorten an attack. Medications are most effective when taken at the first sign of symptoms. Using acute medications too often can lead to medication overuse (rebound) headaches, so it’s important to balance treatment with prevention strategies and talk to your doctor if attacks are frequent or prolonged.
Phases of a Migraine Attack Phases of an Attack A migraine attack often involves distinct phases, though people may experience them differently, says Roderick Spears, MD , a neurologist and the chief of the headache division at Brown University in Providence, Rhode Island. Prodrome Phase This first phase of migraine can occur hours to days before the attack, says Dr. Spears. “It typically involves a change in mood and energy. Certain cravings or excessive yawning can be a sign of prodrome.” People sometimes confuse these prodrome, or premonitory, symptoms with migraine triggers . That’s to say, a person who craves chocolate as a prodrome symptom may mistakenly believe that eating chocolate triggered the migraine attack, according to a story on Everyday Health’s network site Migraine Again . Aura About 25 to 35 percent of people with migraine experience aura, says Spears. “The most common aura is a visual change, with a kaleidoscope-like phenomenon that can last anywhere from five minutes to an hour — but usually much less than an hour,” he says. Other aura symptoms may include tingling sensations, numbness, garbled speech, and clumsiness or weakness.e60dc2a1-f33c-4a05-9b50-8e3e8e59762964248263-1142-48b9-b19f-f33a919feda4 Headache Phase “In most people, [this phase is] marked by a headache on one side of the head that’s throbbing and pulsating, where the pain is typically described as moderate to severe,” says Spears. The headache phase is also associated with sensitivity to the environment. “Light, sound, and odor sensitivity are common, as are nausea and vomiting ,” he adds. In a survey of 1,100 U.S. adults with migraine , 44 percent of participants reported that the headache or attack phase of migraine lasted for up to 24 hours for them, while 33 percent said it could persist for more than 24 hours.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291da31d41-e601-43d1-8ddd-ee531f4aad9d Postdrome or Recovery Phase This phase — in which there’s very mild pain or no pain, but people don’t feel normal — can last 24 to 48 hours, says Spears. “They’re not as sharp cognitively, and they can feel hungover,” he says of people in this phase. “There are also some people who feel elated — almost euphoric — because they don’t have the pain anymore, and they’re full of energy, even verging on hyper,” says Spears.
Acute Drug Treatment to Stop a Migraine Attack Drug Treatment There are several medication options available for treating a migraine attack once it has begun. The type of migraine you have, as well as the frequency and severity of the attacks, is something you should discuss with your doctor when developing a treatment plan. Over-the-Counter Treatment Options For people with mild-to-moderate symptoms, over-the-counter medications are often sufficient.e60dc2a1-f33c-4a05-9b50-8e3e8e59762995749b13-2fdd-464a-9450-3c0c1531e0de Options include: Acetaminophen, aspirin, and caffeine combination (Excedrin Migraine) Acetaminophen (Tylenol) Aspirin (Bayer) Ibuprofen (Advil or Motrin) Naproxen (Aleve) Prescription Treatment Options If over-the-counter options aren’t enough, prescription medications can be used to help stop a migraine in progress or reduce the frequency of attacks. Generally speaking, acute migraine treatments work better the earlier in the attack you take them, before pain has gotten severe. Acute migraine treatments include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976297755f2ed-062d-41bc-9d6a-b69d986686e7 Triptans, such as sumatriptan (Imitrex), naratriptan (Amerge), and frovatriptan (Frova) Ergots, such as dihydroergotamine (Migranal) Gepants, such as rimegepant (Nurtec ODT), ubrogepant (Ubrelvy), and zavegepant (Zavzpret) Ditans, such as lasmiditan (Reyvow) Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac (Voltaren) Each of these treatments works in different ways. Your healthcare provider may recommend one medication or a combination of approaches, based on your health history and symptoms. For example, some drugs aren’t recommended if you have certain health conditions, such as coronary artery disease , a history of stroke, peripheral vascular disease, or uncontrolled high blood pressure. Additionally, women who are pregnant or planning to become pregnant should discuss the relative risks and benefits of acute migraine medication during pregnancy. If your acute migraine treatment plan isn’t working to ease symptoms during an attack, talk to your doctor about other treatment options.
Future Migraine Prevention Migraine Prevention In addition to medications that can stop a migraine attack in progress, there are also drugs that can be taken for prophylaxis, or preventive therapy. Preventive migraine treatments are taken regularly to reduce the frequency and severity of attacks. Options include prescription medications that were originally developed for depression, epilepsy , or high blood pressure, says Mauskop. There’s also a newer class of drugs called calcitonin gene-related peptides, which include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762956a154d9-1e56-4afd-943a-3935b7deb8f5 eptinezumab (Vyepti) erenumab (Aimovig) fremanezumab (Ajovy) galcanezumab (Emgality) Two drugs in the gepants class can also be used to prevent migraine: atogepant (Qulipta) rimegepant (Nurtec ODT) Women with migraine attacks associated with their menstrual cycles may find relief by taking certain types of hormonal birth control or hormone replacement therapy. In some cases, though, these options can make migraine worse.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fbc400bb-8ee8-45d0-85c6-0f4e6dd84c59 Many people do get effective migraine relief from various treatments. “However, if your headaches persist or they last a long time, you should seek medical help from a neurologist or headache specialist,” says Mauskop. “You shouldn’t self-treat migraines if they are unusually long or you’re having them for the first time.”
Self-Care Tips to Shorten a Migraine Attack Self-Care Tips If you recognize the signs that a migraine attack is coming on, you may be able to reduce the amount of time it lasts, according to Spears. “Often, the person with migraine doesn’t always recognize the prodrome phase, but someone close to them — a spouse or family member — may pick up on it.” Spears offers a few tips for potentially reducing the length of a migraine attack: Hydrate as much as possible. Drinking a lot of water is usually helpful. Limit physical activity. If possible, sit or lie down somewhere. Avoid stimulating environments. Go to a dark, quiet place. Some people find that relaxation techniques, such as meditation or massage, help reduce the tension they feel in their face, jaw, or neck. If you can release tension with these techniques, the migraine attack may not be as severe or last as long.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e3c0dee8-dd60-4f34-9780-7e8735faddc9e60dc2a1-f33c-4a05-9b50-8e3e8e597629c12395a2-db0f-427d-b0c4-63c06d271f49 Other people find that putting a cold compress on their temples relieves migraine symptoms and reduces the length of an attack, says Dr. Mauskop.
Medication Overuse Headaches Medication Overuse When people take acute migraine medications too often, they can develop what are known as medication overuse headaches , or rebound headaches. The risk of medication overuse headaches can put people with migraine in a difficult position, says Spears. “Migraine is a condition where the sooner you treat it with medication, the more likely it is that you’ll be successful in stopping it. At the same time, if you take your rescue medication too frequently, it will lead to rebound.” Some of the medications — acetaminophen, aspirin, NSAIDs , triptans, and others — people most commonly use for migraine have been associated with rebound headaches. Talk to your doctor about how often you’re relying on these medications for relief from an attack, as using them multiple days each month to treat migraine can increase your risk of a rebound headache.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dabc1e5b-8d1b-4108-a1d5-de0a91d635d3 Gepants haven’t been shown to cause medication overuse headache, according to Spears. But he still advises limiting the use of drugs in this class.
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