Identifying Triggers

Migraine attacks can be triggered by a number of factors. By identifying and avoiding these triggers, you can help manage your headaches. Keeping a headache journal that tracks the date, time of onset of your headache, a list of medications and other external factors can help you and your doctor track patterns and plan treatment.

Common trigger factors include:

  • Environmental Factors — Migraine headaches can be triggered by environmental conditions including weather or temperature changes, glaring or fluorescent lights, computer screens, strong odors and high altitude.
  • Hormones — Many women and girls have migraine attacks just prior to or during the first few days of their menstrual period. This is due to fluctuations in estrogen levels. Menstrual-related migraines can be more debilitating, difficult to treat and longer lasting than other migraines. They typically subside as women age, particularly after menopause.
  • Sleep — Too much or too little sleep can trigger a migraine in some people.
  • Stress and Anxiety — Emotional stress or daily pressure can trigger a migraine attack in some people. Practicing stress-relieving techniques, such as exercise or biofeedback, may help alleviate migraine.
  • Diet — Alcohol can trigger a migraine attack. Nitrates in foods such as cured meats can trigger migraine within a couple hours of eating them.


Acute Migraine Treatments

Typically, over-the-counter pain relievers such as naproxen, acetaminophen and ibuprofen are recommended as initial treatments. If these do not relieve the pain, your doctor may prescribe a migraine-specific medication such as a triptan. Some triptans are FDA-approved for use in children and adolescents.

Many drugs for acute migraine attacks work best when taken as soon as you feel a migraine coming on. Your doctor will work with you to determine the treatments that are best for you, based on the severity of your attacks and whether you experience other symptoms such as nausea. Treatments, however, don't cure the condition.

Preventive Migraine Treatments

If you experience frequent migraine attacks, your doctor may recommend a preventive medication to make your headaches strike less often and last for shorter periods of time.

Some medications used to treat other conditions — such as beta-blockers for high blood pressure and tricyclics for depression — are also effective in preventing migraine. The benefits and dosages of these drugs when used for migraine, however, are sometimes different than those in the treatment of other conditions.

  • Tricyclic Antidepressants — Although you may not be depressed, your doctor may prescribe drugs such as amitriptyline or doxepin to help reduce the frequency and severity of your headaches.
  • Beta-blockers — A drug such as propranolol may be helpful, and is typically well-tolerated even by people with normal blood pressure.
  • Anti-seizure Medications — Several medicines used in epilepsy (seizures) have been found to be effective in migraine and may be used to prevent attacks.

Be sure to continue taking your preventive medications even while being treated for an acute attack.

If your doctor prescribes medication, be sure to ask:

  • How often to take the medication
  • Should the medication be taken with meals or on an empty stomach
  • What to do if pain or other symptoms persist

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Pediatric Brain Center

Child and Adolescent Headache Program
1825 Fourth St., 5th Floor, 5A
San Francisco, CA 94158
Phone: (415) 502-1914
Fax: (415) 353-2400
Appointment information