Back in April, 2010, I received this, regarding treatment of trad migraine as opposed to MAV:

Migraine: Aspirin and an Antiemetic is a Reasonable Option

A single dose of 900-1000 mg aspirin can substantially reduce migraine headache pain within two hours, for more than half of people who take it. It also reduces any associated nausea, vomiting, and sensitivity to light or sound (photophobia or phonophobia). Formulations of aspirin 900 mg together with 10 mg of the antiemetic metoclopramide are better than placebo at reducing symptoms of nausea and vomiting. These were the findings of a Cochrane Systematic Review using data from 13 studies with 4,222 participants.

Migraine affects about 18% women and 6% of men in western populations, mostly affecting people 30 to 50 years old. The common symptom, whatever type of migraine someone has, is a severe headache, typically once or twice a month, lasting between four and 72 hours. The headache is often pounding, on one side of the head, frequently with nausea, and sometimes with vomiting. Given the numbers of people affected, and the extent of the pain caused, migraine has considerable social and economic impact.

What sufferers want is for the pain to go away completely and quickly, and not return – though for many the headache does return within 24 hours of the first attack. Despite being common and debilitating, many sufferers choose to use only medicines available without prescription from pharmacies (over the counter, OTC medicines), or use OTC medicines to supplement prescription medicines, but good reviews of the evidence have been lacking. In the review published this week, Cochrane Researchers compared the differences in response rates for people taking aspirin alone or aspirin plus an antiemetic with those of people taking placebo or another active agent.

Researchers found that severe or moderate migraine headache pain can be reduced from moderate or severe to no pain in 25% of people (one in four) within two hours by taking a single dose of 900-1000 mg aspirin alone compared to placebo, with pain reduced to no worse than mild pain in 52% (one in two). While aspirin alone reduced some of the associated symptoms of nausea, vomiting, photophobia and phonophobia, aspirin plus metoclopramide was particularly good a reducing nausea and vomiting, though it produced no greater frequency of pain relief.

Researchers also found that a combination of aspirin and metoclopramide had a similar effect to 50 mg of the headache treatment sumatriptan (a serotonin agonist), but that a 100 mg dose of sumatriptan was slightly better at delivering a pain free response within two hours of taking the medication.

In terms of adverse effects, short-term use of the different drugs produced mostly mild and transient adverse effects. These occurred more commonly when taking aspirin than when taking a placebo, and more commonly when taking 100 mg sumatriptan than when taking aspirin plus metoclopramide.

“Aspirin plus metoclopramide will be a reasonable therapy for acute migraine attacks, but for many it will be insufficiently effective,” said the study leader Andrew Moore, who works in Pain Relief and the Department of Anaesthetics at the John Radcliffe Hospital, Oxford, UK.

“We are presently working on reviews of other OTC medicines for migraines, to provide consumers with the best available evidence on treatments that don’t need a prescription.”

Full citation: Kirthi V, Derry S, Moore RA, McQuay HJ. Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database of Systematic Reviews 2010, Issue 4 . Art. No.: CD008041. DOI: 10.1002/14651858.CD008041.pub2

Hi David,

I can vouch for this. Aspirin works far better for me than either ibuprofen or paracetamol. I can’t use too much though otherwise it has a tenancy to cause an upset stomach. The key is to take it on a full stomach. I thought I might have been getting rebound on it but I don’t think that’s the case any more. I just went a few days without needing anything. More about the foods I’ve been eating and the lack of aerobic exercise which I’m fixing now (AGAIN).

Thanks for posting … Scott 8)

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Hi David,

I can vouch for this. Aspirin works far better for me than either ibuprofen or paracetamol. … Scott 8)

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You don’t mention acetaminophen/Tylenol. Does that fail to offer you benefits similar to aspirin? And are you talking about treating acute MAV? I seem to recall you favored valium for that.

This may or may not affect you (or others) but for those people who take low dose aspirin for their heart, as a preventive measure, taking Ibuprofen for pain counteracts the anti-clotting effects of the aspirin. Getting old sucks! :roll:

I’ve never found either aspirin or Ibuprofen to be effective when I have a regular migraine headache. Tylenol sometimes helped.


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You don’t mention acetaminophen/Tylenol. Does that fail to offer you benefits similar to aspirin?

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Panadol (Australian brand name) = paracetamol = acetaminophen = Tylenol (US brand name)

Cheers … S 8)

ive never had a migraine thats responded to otc asprins or any other, only a headache. The only thing that works on true migranes is a jab of a couple of needles at drs. Boy what i give to have a migraine that responds to otcs or migraine that only appears a few times per month, that would be the life!!! :shock:

Very interesting! I didn’t even keep aspirin in the house until recently when my neurologist prescribed a daily “baby” asprin (81 mg) for me for stroke prevention. (Women migraineurs over a certain age with history of aura have slightly higher risk of stroke.) I get only mild to moderate headaches, but moderate headaches can definitely interfere with your life - ibuprofen usually does an OK job but since there’s room for improvement, I think I’ll get some bigger dose aspirin pills (so I don’t have to take a handful of baby aspirin) for my next headache. Thanks, David!

Good post! I like this post, its quite informative and very interesting points that you had given. This is helpful in enhancing the knowledge regarding aspirin. I gathered some good knowledge from this post. I wish that you will add more similar stuff soon.

I notice Ibuprofen relieves aura but worsens migraine for me

Attractive section of content. Your post is great… anyone can understand your post… Thanks for sharing…
Can any one provide the information about tramadol tablet?

Any kind of suggestions would be greatly appreciated.

Asprin works best for me by far. Tylenol and Motrin don’t even make a dent in a big time migraine.

Anybody find that it helps with their dizziness?

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Anybody find that it helps with their dizziness?

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That’s what I’m wondering too…is aspirin effective for the vertigo part at all, or just the headache? (because I don’t get the headache)

If the imbalance/dizziness is being caused/exacerbated by the ear/head pressure the Aspirin will reduce it.

What never ceases to surprise me is that the effect lasts on into the next day or two even sometimes, I suspect it’s the blood thinning mechanism. Always tempts me to want to try a low(er) dose as a preventative. Keep meaning to run that by my GP just to gauge her reaction.