Treatments
Real migraine treatment, explained.
What’s available, what works, and what’s actually right for you. No jargon, no upsells — just the clear picture you should have gotten the first time you asked.
First, the basics
What’s actually happening when you have a migraine.
A migraine is not just a headache. It’s a neurological condition — a brain disorder — that causes attacks typically lasting 4 to 72 hours. The head pain, if it comes at all, is one symptom. The others — light sensitivity, sound sensitivity, nausea, visual disturbances called aura, and cognitive disruption — can be just as disabling as the pain itself.
During a migraine, a wave of electrical activity called cortical spreading depression moves across the brain, followed by a cascade of inflammatory signals. One of the key molecules in this process is CGRP — calcitonin gene-related peptide — a protein that causes blood vessel dilation and amplifies pain signals. Nearly every major advance in migraine treatment over the last decade has focused on blocking CGRP.
Migraine is not psychological, not caused by stress alone, and not something patients should push through with willpower. It’s a genetic, neurological condition — one with real, effective treatments that most patients never receive.
Migraine vs. headache: what’s the difference?
A tension headache is typically a dull, bilateral pressure that responds to ibuprofen and goes away on its own. A migraine is a distinct neurological event — usually one-sided, often throbbing, typically worsened by movement, and accompanied by nausea or sensory sensitivity. True migraines don’t reliably respond to over-the-counter painkillers, and treating them as headaches delays proper care. The fastest way to know: does light or sound bother you during the attack? Does it interfere with normal activity? Does it happen in recognizable episodes with a beginning, middle, and end? If yes, you’re describing migraine.
How migraine is treated
Two kinds of treatment. Most patients need both.
Stopping migraines when they happen — and reducing how often they happen in the first place.
For stopping a migraine that’s already started.
Acute treatments are taken at the onset of an attack. Their job is to abort the migraine — stop the pain, reverse the nausea, end the attack as quickly as possible. Triptans have been the standard for decades. Newer options like gepants and ditans offer alternatives for patients who can’t take triptans or don’t respond to them.
Most acute treatments work best when taken within 2 hours of symptom onset.
For reducing how often migraines happen in the first place.
Preventive treatments are taken daily or monthly — not to stop an attack in progress, but to reduce how often attacks happen and how severe they are when they do. If you have migraines four or more days per month, you’re a strong candidate. CGRP-based preventives have transformed outcomes for patients who previously had few options.
Many preventive treatments take 8–12 weeks to show full effect. Patience and proper follow-up matter.
Most patients with frequent or disabling migraines benefit from both. The right combination depends on your pattern, your history, and what you’ve already tried. This is what a proper migraine care plan looks like — not a single prescription, but a considered, adjusted strategy.
Acute treatments
For when an attack happens.
Medications that stop migraines in progress — what works, who they’re for, what to expect.
The gold standard for stopping an attack.
Sumatriptan · Rizatriptan · Eletriptan · Zolmitriptan · Naratriptan
Wellday’s role: Your clinician reviews your cardiovascular history before prescribing, selects the triptan most likely to work for your pattern, and has alternatives ready if the first doesn't.
Preventive treatments
For fewer migraines, period.
If you have migraines four or more days per month, you’re a candidate.
This is where the science has changed the most in the last 10 years.
The preventive that changed everything.
Aimovig (erenumab) · Ajovy (fremanezumab) · Emgality (galcanezumab) · Vyepti (eptinezumab)
Wellday’s role: This is where we do our most intensive work — handling prior authorization, navigating step therapy, coordinating savings card enrollment ($0–5/month for most commercially insured patients), and following up closely on response.
Beyond medication
Real options that aren’t prescriptions.
Lifestyle approaches, neuromodulation devices, and procedural treatments — when they help, when they don’t, and when they’re the right path.
The foundation under everything else.
Wellday’s role: We provide behavioral guidance as part of every care plan — but we don't ask patients to lifestyle their way out of a neurological condition that requires medication.
A closer look at CGRP
The breakthrough that changed migraine treatment.
01
What is CGRP?
CGRP — calcitonin gene-related peptide — is a protein released by nerve cells during migraine attacks. It causes blood vessels to dilate and amplifies pain signals. People with migraine have elevated CGRP levels during attacks, and some have elevated levels even between attacks.
02
How does CGRP therapy work?
CGRP medications block either the CGRP molecule or its receptor, preventing the cascade from starting. Biologics do this with antibodies that circulate for weeks, providing consistent protection. Oral gepants block the receptor acutely when needed. Both target the same mechanism — different timing and delivery.
03
Who qualifies?
Most adults with migraine 4 or more days per month are candidates. Some insurers require documented failure of 2–3 older preventives first. Wellday is experienced with these requirements and moves patients through step therapy efficiently — documenting trials, submitting authorizations, and appealing denials.
Wondering if CGRP therapy is right for you?
Build your free profile →Educational information
The information on these pages is for general education about migraine and its treatments. It is not medical advice and is not a substitute for evaluation, diagnosis, or treatment by a licensed clinician. Wellday’s care plans are developed individually for each patient based on clinical history, current medications, and personal situation. Always consult with a clinician before starting, stopping, or changing any medication. If you are experiencing a medical emergency or sudden severe headache with new neurological symptoms, call 911 or go to the nearest emergency room.