Which medication is commonly used for abortive treatment of migraines?

• A. Acetaminophen
• B. Sumatriptan
• C. Ibuprofen
• D. Naproxen

Answer: (B)

When treating a migraine in the moment, you want something that directly interrupts the mechanisms driving the attack. Sumatriptan is a prototypical migraine abortive because it targets the trigeminovascular system by activating 5-HT1B/1D receptors on cranial blood vessels and nerve terminals. This causes immediate vasoconstriction and reduces the release of CGRP and other neuropeptides that promote inflammation and pain. By dampening this neurovascular inflammation and neural signaling, many patients experience relief within about an hour. This targeted action makes it a go-to abortive option for moderate to severe migraines or when simple analgesics aren’t enough. Acetaminophen and NSAIDs can help some people, but they’re broader pain relievers and don’t address the specific pathophysiology of migraine as effectively as sumatriptan. Note that sumatriptan isn’t suitable for everyone, especially those with certain cardiovascular conditions or when ergot drugs are used, due to the risk of excessive vasoconstriction.