First, you need to make sure it is a migraine headache. After that, you can see a migraine specialist because there are different types of migraine headaches and a treatment plan needs to be implemented.
Mohammad Reza Bolouri, MD
2. Ensure no rebound headache from caffeine or triptan overuse.
3. Remove environmental, temporal, food, hormonal, medication and exacerbating causes from any other medical conditions if possible.
4. Find an abortive that works. Dont wait to use it. This is either a triptan (by oral or nasal or injection route depending on need) or an analgesic (acetaminophen or non-steroidal (in tablet or solution or nasal or injection route depending on need), or rarely an opiate used alone or in combination. Some trial and error is needed. Repeat the triptan if the headache is still there at 2 hours, even if mild.
5. If headaches are frequent a prophylactic either alone or in combination is necessary from options among antihypertensive or anticonvulsant or antidepressant or CGRP/receptor blocker or botulinum toxin classes.