1. Are you pain free in 2-4 hours?
2. Are you functioning normally in 3-4 hours?
3. Does your headache respond to treatment consistently at least 50 % of the time?
4. Are you comfortable with taking the treatment prescribed and still able to plan your day?

1. Make sure the headache is a migraine and
2. Restrict your use of acute migraine treatment to no more than 9 days per month. If you find that you need more acute medication than 9 days per month, then migraine prevention therapy is likely needed.  

Analgesics & NSAIDs	Nonspecific pain medications Readily available as over-the-counter remedies (including aspirin, naproxen sodium, ibuprofen, acetaminophen, among others) Cost affordable May be given as monotherapy or in combination with other agents (eg. acetaminophen, aspirin, and caffeine) Should not be used in patients who have contraindications for using NSAIDs (hyperacidity syndromes such as ulcer, gastrointestinal esophageal reflux disease, the triad of aspirin sensitivity, nasal polyps, and asthma and kidney disease) Regular or even daily use of these medications may make headaches worse due to medication overuse
Ergotamine, Ergot Combinations Ergot Alkaloids (Dihydroergotamine)	There are currently several different formulations of ergotamine for the acute treatment of migraine including oral, rectal, or intranasal Dihydroergotamine is available as an intranasal, intramuscular, or intravenous treatment May work on more than just activated pathways in migraine Nausea may be a side effect from these medications and also may be part of the migraine itself. Some patients may benefit in taking these agents with another medication to prevent nausea.
Triptans	Readily available with prescription Seven different triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan) Available as oral tablets, orally disintegrating tablets, nasal sprays and subcutaneous injection, so you may request a specific formulation if you have a preference. More migraine specific Some patients may find improved response to triptans if they take their medication early in the course of the attack when pain is mild. Common triptan side effects may include tingling, sleepiness, flushing, throat or chest tightness

• Lidocaine – Used as a nasal spray, lidocaine can offer fast relief of a migraine headache. It is usually taken as you lie down with your head tilted back and turned toward the side of the headache. Lidocaine usually offers about 10 to 15 minutes of relief. After that time, your headache may come back.

• Mixed analgesics – These medicines have a “mixture” of two or more ingredients that help make them stronger and more able to relieve moderate pain. For example, Excedrin Migraine contains acetaminophen, aspirin and caffeine; Midrin contains isometheptene, acetaminophen and dichloralphenazone.

• NSAIDs and acetaminophen – These medicines may help relieve milder headaches. They can be bought OTC (over-the-counter) or with a prescription. Examples of OTC analgesics are acetaminophen (Tylenol) and NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Naprosyn, Naprelan). 

• Opioids – Opioids, or "narcotics," work on the body’s nervous system to block the perception of pain. They are usually used as “rescue medications” when other abortive migraine medicines fail to relieve pain or cannot be taken for some medical reason. Opioids should not be used daily. Use them only "as needed." Ask your health care provider how much and how often you should take this medicine