Many people with migraines wonder:
When is the right time to take my medication?

That's not always easy.

  • The symptoms at the beginning of a migraine often vary.
  • Sometimes it starts with nausea or sensitivity to light.
  • The pain comes later.
  • Initially, the pain often feels only like a diffuse pressure.
  • Then it's difficult to tell: Is it really a migraine or another type of headache?

That's why many people are uncertain.

Early or late intake?

There are two possibilities:

Late intake:

  • We wait to see if it really is a migraine
  • One doesn't want to take unnecessary medication
  • Especially with frequent attacks, you don't want to take too many pills

Early intake:

  • The medication often works faster and better.
  • If you wait too long, the effect may be worse

Important: Deciding solely based on the intensity of the pain is often not enough.

The triptan threshold

There is a tool that can help: the triptan threshold.

This will help you better assess your symptoms.

They evaluate, for example:

  • How intense is the pain?
  • Is the pain on one side?
  • Is it pulsating or throbbing?
  • Does it get worse with physical activity?
  • Are you experiencing nausea or vomiting?
  • Are you sensitive to light or noise?

At the end you will receive a score from 0 to 10.

This score helps you decide:
Now is a good time to take the medication.

What do studies show?

Studies with many patients show:

  • If the medication is taken early (at low pain levels)
    → it works faster
    → pain subsides faster
    → you become pain-free faster.
  • If you wait too long (high score)
    → it takes longer for the medication to work.

Aside from that:

  • You need additional medication less often.
  • There are no disadvantages in terms of tolerability or side effects.

Why do many patients still wait?

Many people take the medication too late because they:

  • are unsure whether it really is a migraine
  • hoping it will get better on its own
  • Fear of side effects
  • Fear of taking too many medications
  • generally want to avoid medication

Approximately 83% of patients only take the medication when their symptoms are severe. At that point, it is often not as effective as when taken earlier.

Important recommendation

  • It is often better to take the medication early.
  • Especially if the symptoms are still mild
  • The triptan threshold can help you find the right time

Note: Good advice from a doctor is very important.

Important rules for triptans

  • in consultation with your doctor early, (e.g., from about 5 points on the scale).
  • The optimal score (threshold) can vary from person to person. This can be determined by comparing the effects of different attacks.
  • Take the full recommended dose all at once, not in small portions.
  • Do not try a painkiller before taking the triptan
  • If the pain returns:
    → Take the triptan again
    → maximum 2 doses in 24 hours
  • If the triptan does not work initially:
    → Do not take the triptan again
    → Use an alternative medication; i.e., a pain reliever with a different mechanism of action (not a triptan).
  • Take acute medication to treat migraine attacks on fewer than 10 days per month.
  • This will help prevent medication overuse headache (MOH).
  • Use only one triptan during an attack; do not mix them.

Source: Göbel, Hartmut: Headaches. Causes, Mechanisms, Diagnosis, Therapy. 4th edition. Berlin: Springer, 2025.