Aspirin is best to prevent migraine with aura

Aspirin is by far the most effective drug for the prevention of migraine with aura, according to Italian researchers from Turin. They reported on 194 consecutive patients who had migraine with aura and who were placed on a prophylactic medication. Ninety of these patients were on 300 mg of aspirin daily and the rest were given propranolol (Inderal), topiramate (Topamax), and other daily medications. At the end of 32 weeks of observation 86% of those on aspirin had at least a 50% reduction in the frequency of attacks of migraine with aura compared with their baseline frequency, while 41% had even better results – at least a 75% reduction. In contrast, only 46% of patients on other drugs had a 50% improvement in frequency. The probability of success with aspirin was six times greater than with any other prophylactic medication, according to the lead author, Dr. Lidia Savi.
Aspirin is not only effective for the prevention of migraines with aura but also for acute therapy of migraine attacks. In previous posts I mentioned that a rigorous analysis of large numbers of patients showed that 1,000 mg of aspirin is better than 500 mg of naproxen (2 tablets of Aleve) and that 1,000 mg of aspirin was as good as 100 mg of sumatriptan (Imitrex) with fewer side effects.
Many health benefits of aspirin, which was originally derived from the willow bark, are becoming widely known. In addition to helping prevent heart attacks and strokes, aspirin has cancer-fighting properties. You may want to read a very interesting article about aspirin, The 2,000-Year-Old Wonder Drug, just published in the New York Times.
Willow
Aspirin formula

21 comments
  1. Maarco says: 05/24/20176:36 am

    I started getting migraines after I was put on some medicine to regulate ear blood pressure (I had vertigo). I am not taking aspirin regularly but whenever I the aura starts I take a couple together with a can of Coke. This caffeine/aspirin combination prevents pain, which I would normally experience 30 minutes after aura begun, completely. Paracetamol/caffeine combo produces the same effect.

  2. Malcolm Gliksten says: 03/27/20176:22 am

    I had migraine auras very occasionally most of my life- then I had a testosterone implant which triggered increase in auras to 3-4 times a month in a cluster over several days. This lasted for 12 years until roughly 2010. I then started taking 75 ml enteric coated aspirin daily – The auras stopped immediately and the only time I have had one since was when I stopped taking the aspirin for a short period.

  3. Rose says: 03/25/20174:55 am

    I have suffered from migraines with aura since I was 10. They got much worse occurring about 3-4 times per week. I have taken migraine preventatives most of my adult life. Just before Christmas 2016 I suffered a mild heart attack. I have been taking 100mg aspirin daily since Dec16. I have had two migraine since then, compared to 4 weekly I am grateful.
    I always take one tablet after dinner. Maybe a higher dose may see the end of migraines forever.

  4. Dr. Mauskop says: 03/23/20179:32 pm

    For some people there is no need to take aspirin daily, but they can take 1,000 mg of aspirin whenever they get a migraine attack. Obviously, aspirin does not help everyone and many people do very well with triptans, such as sumatriptan (Imitrex). For frequent attacks, magnesium, other supplements, Botox injections, and preventive drugs is what’s needed.

  5. vicki says: 03/23/20177:16 pm

    thank you Dr Mauskop for all your comments, am sure it has helped a lot of us migraine sufferers……now i have one for you πŸ™‚ as i’m getting older my migraines are not as frequent and not as intense as they were when i was younger….that’s not to say they don’t still hurt like hell……but i was wondering if just taking the aspirin at the time of the migraine was enough and if so, how many mgs would be the best dose or does aspirin need to be taken all the time to ward off any migraine headaches??

  6. Dr. Mauskop says: 03/02/20176:09 pm

    It may take a few weeks to see if aspirin prevents auras or migraines, but obviously it does not always work or can work only partially.

  7. Kathryn says: 03/02/20175:58 pm

    My Doc put me on 81m baby aspirin a day for aura migraine headache how long does it take for me to see results?

  8. Dr. Mauskop says: 01/30/20179:00 am

    There are no studies looking at the preventive effect of aspirin specifically for auras related to menopause or stress. However, these are among the most common triggers, so it is likely to work as well as for any other aura.

  9. Lynn says: 01/30/201712:18 am

    I am so excited I ran across this site, this might be the answer I ve been looking for. I wonder if the aspirin helps when the auras are menopause and stress triggers? I will be having this conversation with my doctor asap!! πŸ˜€ Thank you.

  10. Dr. Mauskop says: 01/27/20179:11 am

    Yes, 1,000 mg of aspirin can work on its own, but some of my patients need to take it with a nausea medication, such as ondansetron (Zofran) or metoclopramide (Reglan). Both aspirin and fish oil have blood thinning properties, so there is a higher risk of bruising and bleeding if they are taken together. The blood thinning effect of aspirin lasts up to a week after a single dose. If aspirin is taken only occasionally and if the person does not experience frequent episodes of bleeding or has a history of stomach ulcers, taking aspirin and fish oil is usually not a problem. To be safe, you should always check with your doctor.

  11. Kelsey says: 01/27/20173:33 am

    Does 1,000mg of aspirin work on its own or does an anti-nausea also need to be taken? I am trying to find an alternative to Maxalt. Also, can this higher dose of aspirin be taken with fish oil? I take 2 Nordic Naturals Ultimate Omega daily which is 2,000mg of fish oil. As a side note, high quality/ high EPA, DHA fish oil has really helped my migraines! Thank you for recommending it in an earlier post.

  12. Dr. Mauskop says: 01/22/201711:18 pm

    Aspirin can be a very effective prophylactic drug for migraines, but unfortunately aspirin carries the risk of bleeding. Taking a lower dose of 75 or 81 mg instead of 300 mg does not seem to make a difference as far as the risk of bleeding. Taking an enteric-coated aspirin also does not make a difference. Having celiac disease usually does not increase the risk of gastro-intestinal bleeding from aspirin. Being over the age of 70 does increase the risk. A major additional benefit of taking aspirin is that it significantly reduces the risk of developing colorectal, esophageal and gastric cancers, and to a lesser extent, breast, prostate and lung cancer.

  13. Irene coyle says: 01/22/20177:11 am

    I have suffered migraine with aura from a teenager, around 8 years ago I developed cluster migraines with aura and vomiting. At this time I was prescribed citalopram for depression and prescribed maxalt melts to treat the migraine. Recently the migraines were coming very frequently, maybe 4 times a week. I lived in dread of attacks and also had sinus problems, severe neck and shoulder pain. I felt the citalopram were contributing to the headaches and discussed with my doctor about stopping them, she agreed and I reduced dosage immediately, later that same day I had to go to hospital with a vice like tightness in my arm between elbow and hand( I previously had a compound fracture in that wrist with ongoing weakness),. I was prescribed 300 mg of aspirin and a referral to a TIA clinic as a precaution,. I don’t know for sure if it’s coming off citalopram or starting aspirin but I haven’t felt better in years, 10 days with no migraine symptoms! I am also coeliac and do worry about the long term effects of aspirin. Any advice welcome!!

  14. Malcolm says: 10/06/20166:43 am

    I suffered from migraine auras but without any headache. They normally happened monthly in a cluster over 2 or 3 days. They last roughly 20-30 minutes starting with a scintilla of bright light then progressing into a ‘scotoma’ gradually moving towards the perimeter of my vision and eventually disappearing
    About 4 years ago I self medicated, taking a 75mg enteric coated aspirin daily. Since then the auras virtually stopped completely. Once or twice when I ran out of aspirin or stopped taking it the auras came back.

  15. Richie says: 03/22/201612:09 am

    Okay, thanks for answering my questions!

  16. Dr. Mauskop says: 03/19/20168:13 pm

    The short answer is that there are no such recommendations. Aspirin is the oldest anti-inflammatory drug and millions of people have taken it for arthritis and other chronic pain conditions. Some have taken large amounts for many years. The maximum recommended daily dose of aspirin is 4,000 mg however, taking this much aspirin for a long time is definitely risky. It can cause stomach bleeding, ringing in the ears and hearing impairment, kidney damage, and other problems. We don’t know exactly what dose is the best for the prevention of heart attacks, strokes, and cancer, but it is probably between 81 and 325 mg. It is also clear that the gastro-intestinal side effects are dose-related, so 81 mg is safer than 325 mg. On the other hand, there are people who take 1,000 mg daily or more to treat arthritis for years without any side effects. Unfortunately, we don’t know for whom it is safe and for whom it isn’t because a genetic component probably plays a role. At the same time we do know that some people are at an increased risk of side effects. These include elderly people and those with a history of stomach ulcers, kidney problems, hearing impairment, and bleeding problems.
    In conclusion, if you’ve tried many alternatives and 500 mg of aspirin works the best for your migraines and it reduces migraine-related disability, then it may be a worth the risk of taking it long-term. You may want to monitor your stool color – black stool means bleeding and it can occur without any stomach pain or heartburn.

  17. Richie says: 03/18/201611:47 pm

    Is there a recommendation for how long daily aspirin at that higher dose (500 mg) can safely be taken?

  18. Dr. Mauskop says: 02/26/20169:06 am

    Yes, aspirin is effective for all types of migraines. Even a small dose of 81 mg taken for the prevention of heart attacks and strokes was found to be effective in a very large long-term Framingham study. The reduction in migraines was only about 7% but it was a statistically significant number because of the large number of participants. It is possible that taking a higher dose of aspirin, such as 325 or 500 mg daily will work better. Aspirin, just like ibuprofen, naproxen and other NSAIDs carries a risk of bleeding and stomach ulcers, but prescription drugs used for the prevention of migraines have other potential serious side effects and are not necessarily safer than aspirin. The safest and the most effective preventive treatment of migraines is Botox. Its main drawback is cost.

  19. Richie says: 02/25/201611:00 pm

    Is it possible aspirin might be effective for migraine without aura?

  20. nancy says: 05/16/201510:24 am

    I am a long time migraine sufferer with aura. I was put on baby aspirin for hypertension with other drugs and my aura/migraine ceased. I thought it was the vasoconstrictor drug that helped but it was the aspirin. I realized this when I got off the drug and aura was still controlled. my doctor took me off aspirin and my aura/migraine came back. I now know i was the aspirin. I am back on it and letting my doctor know.

  21. Karen Anway says: 02/15/20156:54 pm

    Thank you for this. After 25 years of migraines, most recently 1/week, I came across this article and started trying a low-dose aspirin every day. I haven’t had a migraine for almost a year.

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