• Migraines
• Pain

What is a Migraine Cocktail? How to Use It and More

Medically reviewed and edited by Dr. Banita Sehgal

According to the American Migraine Institution, around 39 million Americans struggle with migraines. The number is believed to be much higher, though, as many people don’t get diagnosed or treated for migraines.

Research from the last two decades estimates that the economic burden of workdays lost due to migraines is around $13 billion in the U.S.

Employees miss on average 4.4 work days due to migraine attacks, while businesses lose 11.4 days each year because of reduced productivity.

People aged 20-50 are most likely to experience migraine headaches, and women are three times more likely to be affected by the condition than men.

Medications used to treat migraines include anti-inflammatories, triptans, and antiemetics, among others.

In this article, we'll take a look at migraines, their symptoms, and how they can be treated and prevented. We’ll also explain what a migraine cocktail is and how it can be prepared.

What is a Migraine Cocktail?

Despite its deceptive name, a migraine cocktail is not a delightful drink you can order at the bar to banish a migraine. A migraine cocktail is a mixture of medications that work together to relieve severe migraine symptoms.

Migraine cocktails are frequently administered by doctors in hospital settings — usually through the vein via an intravenous (IV) drip — but they can also be made at home using OTC medications.

How Do I Know if I Have a Migraine?

A migraine is often thought of as a severe headache, but migraine headaches can be accompanied by a variety of other symptoms as well.

Migraines may also occur in stages. For example, some people may experience severe food cravings or thirst, or visual disturbances — such as black dots and blurred vision — followed by a headache that worsens during physical activity. The final stage may include tiredness or muscle weakness.

Migraine symptoms

Some common migraine symptoms may include:

• A severe, pulsing, or throbbing sensation — typically on one side of the head and it may occur on either side

• Nausea

• Vomiting

• Sensitivity to light (photophobia)

• Sensitivity to sound (hyperacusis)

If you experience any of the above symptoms alongside your headache, you may require migraine treatment.

How Do I Treat Severe Migraine Symptoms?

A migraine attack can strike at any time, and you may not have the necessary medication at hand. In a case like this, there are some simple things you can do to help relieve migraine pain.

Keep in mind that it’s always best to seek advice from your doctor or pharmacist to properly manage a severe migraine.

The following steps can be followed as part of an effective treatment plan for migraine headaches:

• Find a quiet place away from light where you can relax

• Use hot and cold packs to relieve tension

• Take a warm shower or bath

• Consume a caffeinated beverage

• Take a break from your current activity and do something relaxing

If the steps mentioned above don’t relieve your migraine pain, you may need something stronger.

Severe migraine attacks that can’t be eased by taking OTC migraine medications may require a migraine cocktail. These can be made at home, using medicine you can find at a drugstore.

What are the Ingredients of a Migraine Cocktail?

When patients turn up in the ER for treatment of a severe migraine, a combination of the following drugs may be prepared and administered by a healthcare professional.

It can take up to 60 minutes before a migraine cocktail begins to relieve migraine symptoms.

The exact proportions of the “cocktail” will depend on the severity of the migraine and the individual having the migraine attack.

Triptans

Triptan medications are used as first-line treatment for both moderate and severe migraines. The earlier this drug is administered, the more effective it will be in fighting migraine symptoms.

Some examples of triptan medications include:

• Eletriptan

• Almotriptan

• Sumatriptan

• Zolmitriptan

Antiemetics

Antiemetic medications are typically given via injections and are used to treat nausea associated with migraines.

Sedation is one of the side effects of antiemetics.

Some examples of antiemetic medications include:

• Droperidol

• Metoclopramide

• Prochlorperazine

Ergot alkaloids

Ergot alkaloids function similarly to triptan medications, but may cause nausea in some patients. Triptans tend to work more quickly and have fewer side effects.

Some examples of ergot alkaloids include:

• Dihydroergotamine

• Ergotamine

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a good first-line treatment for mild or moderate migraines.

OTC medications such as aspirin and ibuprofen are some good options.

IV fluids

If dehydration has triggered a migraine attack, IV fluids can be used to treat it. IV fluid treatment is especially useful if someone is experiencing vomiting as a migraine symptom.

IV valproic acid

Considered a seizure medication, valproic acid can also be used to treat migraine symptoms.

IV steroids

Steroids, such as intravenous corticosteroids, can be used to treat migraines and are very useful for drug-overuse headaches.

IV magnesium

Intravenous magnesium sulfate can reduce acute migraine headaches within 15-45 minutes of being administered. Oral magnesium can also be used.

Side Effects of a Migraine Cocktail

A migraine cocktail can be a very effective remedy for treating migraine pain, but there are some side effects you should keep in mind.

When a migraine cocktail is administered in a hospital, medical personnel will be available to check up on you. However, if you’ve made your own OTC migraine cocktail, notify your doctor immediately if your side effects are severe or get progressively worse.

The potential side effects of taking a migraine cocktail include:

• Digestive issues, such as diarrhea, nausea, or vomiting

• Sleep disturbances

• Abdominal pain

• Dizziness or medication-overuse headaches

The OTC Migraine Cocktail

If you experience a severe migraine attack and you’re unable to go to the hospital for treatment, you can make your own migraine cocktail at home.

You may have most of the ingredients in your medicine cabinet, but you can find all of them at your local drugstore.

How do I prepare an at-home migraine cocktail?

A migraine cocktail can be made at home using a combination of the following ingredients:

• Aspirin (250 mg)

• Acetaminophen (250 mg)

• Caffeine (65 mg which is about 5.5 ounces of brewed coffee)

When taken together, this combination of medications can help relieve a severe headache.

Are Migraine Cocktails Safe?

Though there are side effects, migraine cocktails are generally safe — especially if you go to the hospital for migraine treatment where doctors can monitor you and treat any bad reactions, should they arise.

If you experience worsening side effects after taking medication for your migraine headache, contact your doctor or emergency services immediately.

While there is no definitive cure for a migraine, you may be able to minimize the frequency of migraine attacks and reduce the severity of migraine symptoms by taking a holistic approach to migraine prevention.

Lifestyle changes

By making some simple changes to your lifestyle, you can help prevent a migraine attack or lessen its duration.

Some long-term changes that will help you manage migraine symptoms while improving your overall health, include:

• Reducing stress

• Building good sleeping habits

• Quitting smoking

• Keeping a migraine diary to track your triggers

• Maintaining a good posture

Practicing relaxation techniques

Stress is a known trigger of severe headaches and migraines, so any activity that relaxes the body and mind may benefit those who experience regular migraine attacks.

Some relaxing practices you may want to try, include:

• Meditation

• Breathing exercises

• Yoga or light stretching

• Listening to calming music

Getting regular exercise

Exercising combats stress, which is one of the main triggers of migraines. In addition, it also improves sleep quality and lifts your mood.

Alternative therapy

If migraine cocktails don’t sound too appealing, there are some alternative migraine treatments you can try, including:

• Acupuncture

• Botox injections

• Massage therapy

• Daith piercings (piercing a ridge of cartilage — called the helix — above your ear canal to target a pressure point that relieves headaches).

How to Prevent Migraine Attacks

Some great ways to help prevent migraines include:

• Living a healthy, balanced lifestyle where stress is managed properly

• Prioritizing relaxation

• Regularly getting a good night’s rest

• Eating a balanced diet

• Getting regular exercise

• Keeping a migraine diary to identify your triggers

When Should I See a Doctor for Migraines?

If you experience severe migraine headaches, with symptoms that do not disappear within 72 hours after you’ve taken a migraine cocktail or OTC medication, you should contact a doctor.

You may require migraine therapy — which can be a combination of drugs delivered via an IV infusion to relieve the most severe symptoms of your migraine.

A doctor will also be able to run tests to rule out any life-threatening conditions that may be causing your headache, such as a cancer or stroke.

Where Can I Learn More About Migraine Management?

Do you get frequent headaches that just don’t let up no matter what medication you take? You may be one of the millions of Americans affected by migraines. But help is available at LifeMD. Schedule a video appointment with a board-certified doctor or nurse practitioner so you can start managing your migraines.

Dr. Banita Sehgal

Dr. Sehgal received her medical degree from Western University in Los Angeles and trained as Chief Resident at White Memorial Medical Center, also in Los Angeles. She’s been practicing medicine for 20+ years and has a specific interest in women’s health.

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