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The main steps in treating your/your �����г���Ƶ’s migraines are:

1. Setting and keeping healthy lifestyle habits
2. Recognizing and avoiding triggers
3. Using medications to stop or interrupt headaches once they have started (if needed)
4. Using medications to prevent the headaches from happening as often (if needed)
5. If all else fails, using medicines to deal with a headache that will not go away (“rescue” options)
6. Trying non-medication (complementary) treatment options
7. Proper general health measures

This includes proper diet, sleep, and exercise. If these basic health measures are ignored, other treatments are less likely to help.

Diet

A well balanced diet with healthy meals three times a day is recommended.

Missing or delaying meals is a common trigger for headaches.

Drinking high caloric beverages (sodas, energy drinks, etc.) can trigger migraines. Doctors also recommend that �����г���Ƶren don't drink caffeinated beverages often. 

Sleep

Getting enough sleep is critical to good health and improving your �����г���Ƶ's headaches. Unfortunately, many �����г���Ƶren with frequent or uncontrolled migraines don't sleep well, especially teenagers.

Your �����г���Ƶ’s doctor may need to treat your �����г���Ƶ's sleep problem as well as their headaches.

Activity/Exercise

Doctors recommend that �����г���Ƶren get at least 30 minutes per day or some enjoyable activity such as walking, hiking, playing sports or swimming. Physical activity can help �����г���Ƶren with migraines.

Staying active also improves mental health as well as sleep and improves a �����г���Ƶ’s ability to cope with headaches.

Recognizing & Avoiding Triggers

An important step in preventing migraines involves identifying what triggers can "spark" your �����г���Ƶ's migraines.

Your doctor will give you a list of potential headache triggers. Remember that everyone is different and each �����г���Ƶ's triggers may be different.

Sometimes triggers are not obvious or cannot be identified. It may be helpful to track your �����г���Ƶ’s headaches on a calendar to try to recognize which triggers might apply to your �����г���Ƶ.

Many foods can trigger migraines, including:

• prepared meats,
• cheeses, and
• chocolate.

These things can also trigger migraines:

• dehydration (not drinking enough fluids throughout the day),
• stress (both good and bad),
• high altitude,
• lack of adequate sleep, and
• irregular routines.

Peaceful sleep and healthy, regular meals are the best ways to manage migraines.

Medications To Stop or Interrupt Headaches

Infrequent migraines (less than 4 per month) that last less than 24 hours and don't interfere with school attendance or other activities can be treated with interruptive medications.

These medicines, sometimes called rescue medications, all work best when given as early as possible after the headache starts. In general, the longer a headache lasts, the harder it can be to stop.

We usually recommend ibuprofen (Motrin, Advil), or naproxen sodium (Aleve). These work best if combined with rest.

If ibuprofen alone does not help, a combination of ibuprofen plus caffeine (60 to 90mg) may be better. You can purchase caffeine tablets over the counter in your local pharmacy.

Triptan Medications

Neurologists believe that the triptan family of medications, such as sumatriptan (Imitrex), zolmitriptan (Zomig), frovatriptan (Frova), rizatriptan (Maxalt) and almotriptan (Axert), are the best medications for treating migraines in adults.

Although triptans aren't approved by the FDA to treat �����г���Ƶren and younger teens, pediatric neurologists often recommend them when headaches don't get better with appropriate doses of ibuprofen or naproxen.

Neurologists believe that triptans are very safe in �����г���Ƶren, but they should be used cautiously and not more than three times per week.

Medications to Prevent Migraines from Happening

When migraines happen as often as once per week, if they last several days at a time, or if migraines interfere with your �����г���Ƶ's school attendance or performance, or cause neurological problems, taking a daily medication to prevent the headaches may be a good idea.

A variety of medicines can prevent headaches in �����г���Ƶren and adolescents. The “best choice” depends on your �����г���Ƶ’s:

• age and weight,
• the side-effects of the medication, and
• the presence of other factors, such as depression, insomnia, or asthma.

These preventive (or “prophylactic”) medications include:

• cyproheptadine (Periactin),
• topiramate (Topamax),
• propranolol (Inderal),
• divalproex sodium (Depakote),
• amitriptyline,
• imipramine,
• gabapentin (Neurontin),
• verapamil, and
• others.

We often recommend cyproheptadine for �����г���Ƶren of normal weight under 10 years of age and topiramate for �����г���Ƶren over 10.

Medications to Help With a Migraine That Won't Go Away

Your pediatric neurologist will help you and your �����г���Ƶ’s primary care doctor develop a plan that can be used at home to treat a headache that doesn't seem to be responding to the usual treatments listed above. This should help you avoid having to call your �����г���Ƶ's doctors urgently and should keep you from having to bring your �����г���Ƶ to the emergency room for a severe headache.

For a severe headache that isn't getting better, getting to sleep is the goal. We recommend that your �����г���Ƶ lie down in a darkened, quiet room. We may prescribe promethazine (an anti nausea medication) combined with either diphenhydramine (Benadryl) or hydroxyzine (Atarax, Vistaril) in order to induce a deep sleep that may break the headache cycle.

If your �����г���Ƶ is vomiting, you may need to give your �����г���Ƶ promethazine as a suppository. You may need to give your �����г���Ƶ these medications as often as every six hours for a day or two to make sure your �����г���Ƶ sleeps for a longer period of time to stop the headache. 

Sometimes your doctor may choose to prescribe a medication that is sprayed into the nose (intranasal Imitrex or dihydroergotamine [DHE; Migranal]) as a way of treating headaches that don’t stop.