What Is A Migraine Cocktail And When To Use IV Treatment

Intravenous therapy is becoming more widespread as a treatment to address a variety of health issues and concerns. But can IV therapy really help address migraines? How do treatments work? Keep reading to learn more about what a migraine cocktail is and decide if it might be the right treatment option for you.

What are migraines?

Migraines are severe headaches characterized by intense throbbing pain or a pulsing sensation, resulting from a neurological condition. Migraine pain often affects one side or specific area of the head. Migraines typically run in families and can affect all ages, but are most common in people assigned female at birth (AFAB).

Types of migraines

There are several types of migraines differentiated by symptoms and other factors. It is not uncommon for people to experience more than one type of migraine. Migraine with aura and migraine without aura are two of the most common types of migraine.

Migraine with aura

25 percent of migraine sufferers experience auras, which have various traits. Auras typically precede head pain but may continue through the attack. Auras may also start at the same time as the head pain. (These assume the migraine attack is not caused by another health problem and transient ischemic attack has been excluded.)

Typically, migraine attacks with auras will include at least two attacks with these characteristics:

An aura with at least two of these traits

• At least one symptom is only on one side of the head
• Aura occurs with the attack or up to 1 hour before it begins
• Each symptom lasts between 5 minutes and up to 3 hours
• At least one symptom spreads gradually (taking at least 5 minutes)

Temporary auras with reversible symptoms

• Weakness or difficulty moving (may last up to 72 hours)
• Language and speech problems
• Vision problems (most common symptom)
• Sensory problems such as dizziness, numbness, or tingling on the body, face, or tongue

Aura symptoms related to the brainstem

• Difficulty talking or unclear speech
• Double vision
• Eye problems in one eye (retinal migraines), including Flashes of light Blind spots temporary blindness
• Inability to control body movement
• Tinnitus (ringing in the ears)
• Vertigo (feeling like you are spinning)
• Migraine without aura

Usually, people with migraines do not experience aura, and have had at least 5 attacks with the following characteristics (this assumes attack is caused by another health problem or diagnosis):

Attacks last 4-72 hours

Attack has at least one of these symptoms:

• Nausea, vomiting, or diarrhea
• Phonophobia (sensitivity to sound)
• Photophobia (sensitivity to light)

Attack has at least two of these traits:

• Pain is pulsating or throbbing
• Pain gets worse when you move
• Pain level is moderate-severe
• Pain is only on one side of the head
• Episodic vs. chronic migraines

Migraines can be further classified based on their frequency and duration. Episodic migraines are more common than chronic migraines, which affects 3-5% of Americans.

Episodic migraines

Migraines may be diagnosed as episodic if:

• At least 5 migraine attacks have been experienced
• Attacks occur less than 15 days each month
• Migraine episodes last 4-24 hours
• Other symptoms typical of episodic migraine include nausea, vomiting, and sensitivity to light and sound.

Chronic migraines

Chronic migraines have the following characteristics:

• Migraine headaches are experienced 15 or more days a month for a duration of 3 months or more
• Additional migraine symptoms appear for at least 8 of those days
• Attacks can last more than 24 hours

In one study, chronic migraine episodes averaged 65 hours without treatment, and 24 hours with treatment. Comparatively, episodic migraine duration without treatment is 38 hours, and 12 hours with treatment.

What causes migraines?

Researchers are still trying to determine a conclusive cause of migraines, but believe they are linked to abnormal brain activity. They appear to affect brain chemicals, blood vessels, and nerve signaling.

While the underlying cause of migraines has not yet been uncovered, there are various factors that can trigger migraine attacks according to sufferers, including:

• Alcohol or caffeinated drinks
• Anxiety or excitement
• Barometric pressure changes
• Bright lights
• Certain medications (ie oral contraceptives, nitroglycerin)
• Dehydration
• Extreme stress
• Food additives [ie nitrates, aspartame, or monosodium glutamate (MSG)]
• Hormone changes in AFAB people
• Loud sounds
• Poor sleep quality or disruption to sleep patterns
• Skipping meals
• Smoking
• Strenuous physical activity (outside of normal levels)
• Travel
• Weather extremes (ie, severe heat)

How are migraines normally treated?

Unfortunately, there is no cure for migraines, however there are various ways to manage migraine attacks. A migraine treatment plan can vary depending on a number of factors, including:

• Age
• Frequency of attacks
• Severity of attacks
• Type of migraine attack
• Any symptoms that accompany attacks

Impact of other comorbid conditions or medications

Treatment plans often include lifestyle changes, such as managing stress and avoiding migraine triggers as much as possible. They often combine strategies to help prevent and relieve migraines. A doctor can prescribe medications to help prevent headaches, reduce frequency of attacks, and reduce severity of symptoms during an attack.

Other ways you can address migraines include:

• Alternative care, including acupressure, acupuncture, and meditation
• Over the counter (OTC) medications to relieve pain and other symptoms such as nausea or vomiting
• Hormone therapy
• Counseling

Doctors recommend that you keep a journal of migraine attacks over a few weeks or months. This diary can help identify the type(s) of migraine(s) you experience as well as possible triggers.

Entries should include:

• Date and time migraines start
• Description of what you were doing when the migraine began
• What symptoms you are experiencing, including where pain is located and other symptoms like nausea
• What time the migraine ended
• What attempts were made to treat the migraine, if any, and whether they worked

What is a prescribed migraine cocktail?

A prescribed migraine cocktail is a specific blend of prescribed medications delivered via IV infusion. A 2019 study found that 40% of patients experienced pain relief and 50% had less dizziness after receiving infusion treatments.

Administering treatment via IV has advantages over oral medications, including:

• Hydration: IV treatments quickly hydrate the body with fluids and electrolytes your body needs to function at its best. Ensuring proper hydration can also help minimize side effects of medications included in a migraine cocktail.
• Works faster: IV infusions deliver ingredients directly to the bloodstream, allowing them to start working more quickly. A migraine cocktail typically begins working in an hour, versus oral treatments that may take longer to work because they must be processed by the digestive system.
• Better absorption: Oral medications get broken down by the digestive system, meaning only about 50% of the ingredients end up being absorbed by the body. IV therapy has a significantly higher absorption rate, approximately 90%.

There are a number of medications that may be included in a migraine cocktail blend. Cocktails can differ from provider to provider, so you should always check to find out what is in a provider’s blend before receiving treatment.

Examples of medications commonly found in migraine cocktails include:

• Antiemetics are typically prescribed to help relieve nausea or vomiting, though they can help relieve pain in some cases as well. Common examples found in migraine cocktails are metoclopramide (Reglan) and prochlorperazine (Compazine).
• Ergot alkaloids have anti-inflammatory effects, which are believed to help ease pain by narrowing blood vessels (known as vasoconstriction) in the brain. Dihydroergotamine is an ergot alkaloid frequently used in migraine cocktails.
• Steroids help ease pain and inflammation and can also work to prevent migraines for the few days following a migraine cocktail treatment.
• Triptans, like ergot alkaloids, have anti-inflammatory effects to help stimulate vasoconstriction. A common triptan found in migraine cocktails is sumatriptan (Imitrex).
• Valproic acid (Depakote) is a seizure medication sometimes used to treat severe migraine attacks.

Are there OTC or natural migraine cocktail options?

Some people prefer to use over the counter (OTC) and/or natural treatments to address migraine issues. Sometimes this is a matter of personal preference, while in other cases, medication allergies, contraindications with other medications, or impact on other health conditions can play a role in this decision. Thankfully, OTC and vitamin IV formulas can offer relief to migraine sufferers.

OTC migraine cocktail blends

Some typical ingredients in OTC migraine cocktails include:

• Acetaminophen relieves pain by reducing prostaglandin production. Prostaglandins are natural compounds found in the body, composed of fats. They function similarly to hormones, and can create different effects depending on which receptors they affect.
• Prostaglandins can increase pain sensitivity and cause uterine cramping.
• Aspirin helps reduce inflammation and pain.
• Caffeine can help stimulate vasoconstriction.

You may be familiar with OTC migraine medications like Excedrin, which typically are a blend of these ingredients. As with prescribed migraine cocktails, intravenous delivery helps ensure they are fully absorbed, can begin working faster, and that your body stays hydrated.

Vitamin cocktails for migraines

Although not specifically formulated for migraines, there are several common vitamin therapy formulas that can help migraine sufferers. While the names may differ from provider to provider, blends are generally formulated to achieve similar results.

Examples of common vitamin IV therapy formulas that can benefit people who suffer from migraines include:

• Myer’s Cocktail
• All-Inclusive
• Recovery
• Super Immune Boost

These formulas have different blends of various vitamins to help supplement the body with the nutrients it needs to function at its best.

Typical ingredients and their benefits for migraines include:

• B-Complex vitamins: Various B vitamins have health benefits that can help migraine sufferers, however Vitamin B2 in particular has been studied for its migraine benefits. Also known as riboflavin, Vitamin B2 is believed to help reduce oxidative stress and brain inflammation that occur with migraine. Nine studies showed significant pain relief and decrease in migraine attacks after taking Vitamin B2 for three months, with no serious side effects.
• Vitamin B12: Headaches are one of the most common signs of Vitamin B12 deficiency. A study of 140 people in 2019 found that migraine sufferers had some of the lowest levels of B12. It was also noted that those with the highest B12 levels were 80% less likely to experience migraines.
• Vitamin C: Vitamin C is well-known for its antioxidant properties, which can help protect cells from free-radical damage related to inflammation caused by migraine.
• Magnesium: Like Vitamin B12, magnesium deficiency has been linked to migraine. It is believed magnesium helps prevent and treat migraines in a few ways. Magnesium is believed to help reduce proinflammatory signaling and excessive stimulation of brain receptors, both of which are involved in the development of migraine. It also seems to particularly benefit those who suffer with premenstrual migraines, which have been linked to magnesium deficiency. A review of 21 studies determined that intravenous administration of magnesium can substantially relieve acute migraine. Magnesium was also found to help reduce the frequency and severity of attacks.
• Glutathione: The most abundant antioxidant in the body, glutathione also helps break down toxins which may trigger migraine. Combined with IV fluids, glutathione can help the body break down and flush toxins faster.
• Zinc: Zinc deficiency has also been linked to migraine attacks. One study found that zinc supplementation helped reduce the frequency of migraine attacks, though it did not appear to improve headache severity or duration.

Many IV therapy providers also provide the option to add specific ingredients to pre-formulated cocktails. Migraine sufferers who want the benefits of IV therapy can request additional anti-inflammatory and anti-nausea OTC medications to improve results from treatment.

Are there any side effects to migraine cocktail treatments?

Side effects from treatments can vary depending on the migraine cocktail formula you choose. When consulting a medical professional about the right migraine cocktail for you, it’s important to disclose any health conditions, medications you are taking, and any allergies you may have to avoid experiencing side effects.

There are a few possible side effects associated with the IV administration method, including:

• Air embolism
• Infection at injection site
• Vein damage

The risk of these side effects is significantly reduced when treatments are administered by a licensed and trained healthcare professional following standard safety protocols.

Prescribed migraine cocktails

Antiemetics may cause:

• Muscle tics or tremors
• Restlessness

Ergot alkaloids may cause:

• Drowsiness
• Nausea or vomiting
• Upset stomach

Steroids may cause:

• Dizziness
• Difficulty sleeping
• Nausea

Triptans may cause:

• Aches and pains
• Fatigue
• Tightness in chest, jaw, or neck

Valproic acid (Depakote) may cause:

• Diarrhea
• Dizziness
• Drowsiness

OTC migraine cocktails

While generally considered safe, people with certain health conditions may be advised to avoid OTC migraine formulas. You should discuss your health history with your provider before receiving treatment, especially:

• Those with asthma
• Those with heart, kidney, or liver disease
• Those with a history of conditions like heartburn or ulcers
• Those with particularly severe migraines
• Those who are pregnant or breastfeeding
• Those who are taking medications, especially blood thinners, diuretics, other NSAIDs, or steroids.

Potential side effects of OTC migraine cocktails include:

• Abdominal pain
• Diarrhea
• Dizziness
• Difficulty sleeping
• Medication-overuse headache
• Nausea or vomiting

Natural vitamin IV cocktails

Vitamin IV side effects are generally caused by having too much of a vitamin in your system. Some examples include:

• B-complex vitamin overload can cause high blood sugar, liver damage, and vomiting
• Vitamin C overload may cause diarrhea and nausea, iron overload, and kidney stones
• Glutathione overload may result in allergic reactions, abdominal cramping, and difficulty breathing
• Vitamins can also interact with medications you are taking. Some medications may cause vitamin deficiencies. In other cases, vitamins can change the way your body breaks down medications, altering the absorption rate which can increase or decrease their effectiveness.

Regardless of which migraine cocktail you choose, you should make sure to consult with a medical professional during your pre-treatment health screening to make sure you get the safest and most effective option possible.

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