Doctors are generally open to switching medications if you explain your concerns, especially if your current treatment isn’t effective or causes side effects.

Finding the right migraine medication often takes time, and it’s not uncommon for people to have challenges with treatment effectiveness, leading some to give up on their current medications.

Having a conversation with your doctor about your options can help you find the right treatment to bring the relief you need.

Here are steps to help you get ready for your appointment:

  • Track your symptoms: Keep a migraine diary that includes the frequency, duration, severity, and triggers of your migraine attacks, along with how well your current medication works.
  • Note side effects: Write down any side effects you’re experiencing, even if they seem minor.
  • List concerns and questions: Prepare specific questions about switching medications, like alternative options, dosage changes, or expected side effects.
  • Research options: Look into different migraine medications, including new treatments or alternatives that might be suitable for your situation. This can help guide your discussion with your doctor.

Consider why you want to switch medications

Switching migraine medications is common, especially if the current treatment isn’t effective. A 2022 study found that only 24.9% of patients remained on their prescribed migraine prophylactic after 24 months. Among all patients, 27% switched to a different prophylactic medication, while 50% discontinued treatment without switching.

Common reasons for discontinuing a medication include insufficient relief, bothersome side effects, or difficulty tolerating it over time.

Discontinuation rates can vary by drug class. For instance, angiotensin receptor blockers and CGRP-related medications had the best persistence, while most other classes showed similar discontinuation rates.

Understanding your reasons for wanting to switch can help increase the chances that your next treatment is more suited to your needs.

Here are some practical tips for talking with your healthcare professional about switching migraine medications:

  • Be honest about your current experience: Share how your current medication is working — or not working. Be specific about medication side effects, how often you take it, and the level of relief it provides.
  • Explain how migraine headaches affect your life: Describe how your episodes disrupt your daily activities, work, relationships, and overall well-being. This helps your doctor prioritize your needs and find a treatment that fits your lifestyle.
  • Discuss new treatment options: Ask about the latest migraine medications, including preventive options to reduce frequency and acute treatments for symptoms. A 2023 review of the Finesse Study found that 42.8% of people who switched to fremanezumab — a medication targeting a specific migraine pathway — experienced at least a 50% reduction in migraine days. The response was higher in episodic migraine (48%) compared to chronic migraine (36.5%).
  • Learn about side effects: Ensure you understand the potential side effects of any new medication, including how they might affect your daily life. Ask about strategies to manage side effects and what to do if they become problematic.
  • Voice any concerns: Openly discuss worries about changing your treatment plan. This could include concerns about withdrawal from your current medication, adjusting to a new treatment, or insurance coverage.
  • Share your goals for treatment: Discuss what you hope to achieve with a new medication, whether it’s fewer headaches, quicker relief, or fewer side effects. Clear goals help your doctor recommend options that align with your expectations.
  • Ask about nonmedication options: Ask about complementary treatments like lifestyle changes, dietary adjustments, stress management techniques, or physical therapies. These can enhance the effectiveness of your medications.

Questions to ask

  1. What are the potential benefits and risks of switching to a new medication?
  2. Are there newer treatments or drug classes that might work better for my headaches?
  3. How will the new medication interact with my current medications or health conditions?
  4. What side effects should I expect with the new medication, and how can I manage them?
  5. How long will it take to see results with the new medication, and what should I do if it doesn’t work?

A treatment plan is a step-by-step guide that shows how to manage your migraine headaches, including medications, lifestyle changes, and follow-up care.

Creating a new treatment plan when switching medications is important to help make the transition easier, reduce side effects, and track how the new medication works to control your headaches, giving you better results.

Consider the following:

  • Work with your doctor to create a transition strategy: Ask for a step-by-step plan for switching medications, which may involve tapering off your current medication, starting the new one at a low dose, and gradually adjusting it.
  • Schedule follow-up appointments: Set up regular check-ins to monitor your progress, evaluate how the new medication is working, and address any concerns.
  • Incorporate lifestyle changes: Work with your doctor to identify lifestyle adjustments that can complement your new treatment plan, such as improving sleep habits, managing stress, or tracking migraine triggers, to enhance the effectiveness of the medication.

Consider your treatment options

Different treatments work for different people, and factors like effectiveness, side effects, and your health needs should guide your decision to ensure better symptom management.

A 2024 review compared 17 medications for treating acute migraine headaches to see which are most effective in relieving pain. It showed that all active medications worked better than a placebo, with eletriptan being the most effective for pain relief within 2 hours.

Other medications, such as rizatriptan, sumatriptan, and zolmitriptan, were also effective but slightly less so. Among the options, eletriptan and ibuprofen provided the best-sustained relief for up to 24 hours.

While newer medications like lasmiditan, rimegepant, and ubrogepant were tested, they weren’t as effective as the triptans (eletriptan, rizatriptan, sumatriptan, and zolmitriptan).

Study authors emphasized that triptans should be considered as the first choice for treating migraine attacks, although cost and patient health factors should be considered.

Switching migraine medications can be a positive step toward better relief, but it’s important to work closely with your doctor throughout the process.

By creating a clear plan, staying involved, and being open about your experiences, you can make the transition smoother and find a treatment that works better for you.