The medications most used (and abused) by migraine sufferers are analgesics or pain-killers. We are constantly bombarded by advertising for analgesics, and it is little wonder that the first thing tried by most of those with migraines is over-the-counter (OTC) analgesics such as Tylenol, Excedrin, Anacin, etc. These analgesics and their prescription-only relatives can be an effective solution for some patients, especially those who have infrequent (once-a-month or less) migraines. However, many patients end up taking analgesics daily or even many times per day. Taken in this manner, the analgesics often "take the edge off the pain" but then when they wear off (for example, on awakening the next morning), the pain is back. Gradually, the patient becomes dependent on the analgesics and can not go anywhere without them. Taking analgesics on a daily basis can have long term deleterious effects on the kidneys and liver as well as making the headaches more frequent. Sometimes patients who get into this cycle are referred to as having analgesic abuse syndrome. Such patients need to be put on a prophylactic medication and detoxified from their analgesics, after which they are usually much better in terms of their headaches.

Some frequently employed non-narcotic analgesics are:

  • Acetaminophen (Tylenol)

  • Aspirin
  • Excedrin (acetominophen, caffeine)
  • Anacin
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDS) such as ibuprofen (Motrin, Advil), naproxen (Naprosyn).

Examples of narcotic analgesics, all of which require a doctor's prescription because of abuse potential are:

  • Propoxyphene (in Darvocet)

  • Codeine (in Tylenol #3)
  • Butorphanol (Stadol)
  • Oxycodone (in Percocet)
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Morphine
  • Merperidine (Demerol)

Combination drugs exist that combine analgesics:

  • Fiorinal (aspirin, caffeine, butalbutal)

  • Fioricet, Esgic (acetominophen, caffeine, butalbutal)
  • Darvocet (acetominophen, propoxyphene)
  • Percocet (acetominophen, oxycodone)