When to Call My Doctor or Go to the ER for Migraine?

Health Professional

Full Question:

How do I know when I should call my doctor or go to the ER for a migraine? Thanks, Roxie.

Full Answer:

Dear Roxie:

There are some situations in which you should get in touch with your doctor:

  • When a migraine lasts more than 72 hours without a four-hour break while awake, it's termed status migrainousus, and you should contact your doctor.
  • If you're having the worst head pain you've ever had, you should contact your doctor.
  • If you're vomiting repeatedly and can't get it under control, you should contact your doctor.
  • If you're having new and frightening symptoms, you should contact your doctor.

If you can't contact your doctor, those are reasons to go to the ER or an urgent care facility.

The emergency room is one of the worst places for migraine treatment. They don't know you, your health history, or what works best for you. Additionally, many ER physicians know little about migraine. To add to all of that, many ER staffers are suspicious of patients who go to the ER for a migraine because people who go to the ER just wanting "drugs" often say they have a migraine because there's no diagnostic test to show whether they really have migraine or not. Take a look at Migraine and the ER - Not the Best Solution.

To manage our migraines as well as possible and avoid the ER, there are three types of treatments we should have:

  1. Preventive treatment. If you're having three or more migraines a month, talk with your doctor about preventive treatment.
  2. Abortive treatment. This is treatment taken when you get a migraine, and it's purpose is to abort the migraine, to actually stop the migrainous process. The most widely prescribed abortive treatments are the triptans - Imitrex, Maxalt, Zomig, etc. There are also ergotamine medications and Midrin equivalents.
  3. Rescue treatment. Rescue treatments are intended for use when abortive treatments fail. See Migraine Rescue Treatments – Vital to Our Treatment Regimens.

Thanks for your question,
David Watson, MD, and Teri Robert


About Ask the Clinician:

Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. He and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about _ Dr. Watson_ or more about _** Teri Robert** _.

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