Acute Treatment: Early intervention is critical. Over-the-counter NSAIDs (e.g., ibuprofen) or acetaminophen suffice for mild attacks. For moderate-to-severe migraines, triptans (e.g., sumatriptan, rizatriptan) are first-line, targeting serotonin receptors to constrict vessels and inhibit pain pathways. Oral triptans suit most patients; nasal sprays or injectables offer faster relief for rapid-onset attacks. Neurologists caution against overuse (more than 10 days/month) to prevent medication-overuse headache. Adjuncts like antiemetics (e.g., metoclopramide) manage nausea. For refractory cases, calcitonin gene-related peptide (CGRP) receptor antagonists (e.g., ubrogepant, rimegepant) provide non-vasoconstrictive options, safe for patients with cardiovascular risks. Emergency settings may use IV dihydroergotamine or ketorolac, with neurologists monitoring for side effects like chest pain or sedation.

Non-Pharmacological Strategies: Trigger identification (e.g., stress, sleep disruption, caffeine) through headache diaries guides lifestyle changes. Cognitive-behavioral therapy and biofeedback reduce stress-related attacks. Regular sleep, hydration, and exercise are emphasized. Neuromodulation devices, like transcutaneous supraorbital stimulators, offer adjunctive relief for non-responders. Neurologists advocate acupuncture or mindfulness for select patients, though evidence varies.

Monitoring and Comorbidities: Regular follow-up tracks treatment efficacy and side effects. Neurologists screen for depression, anxiety, or sleep disorders, which exacerbate migraines. Patient education on realistic expectations and adherence prevents overuse or discontinuation. For refractory cases, clinical trials explore novel therapies like PACAP inhibitors. Personalized, multidisciplinary care ensures optimal migraine control and functional restoration.