100 Migraine Drugs, A to Z: butorphanol

September 3, 2018

Butorphanol nasal spray (Stadol NS) is approved by the FDA for the treatment of acute migraine attacks. It belongs to the agonist-antagonist type of opioid (narcotic) drugs, while morphine, methadone, oxycodone, and most other opioids are pure agonist drugs. The agonist-antagonist drugs were originally thought to be less addictive, but unfortunately this is not the case.

Also, opioid analgesics despite being very strong pain killers, are not very effective for the treatment of migraines. This is in part due to the fact that migraine pain is accompanied by nausea (and other symptoms), while opioids tend to cause nausea or make it worse. Other side effects of butorphanol include constipation, upset stomach, dizziness, drowsiness, feeling strange or even having frank hallucinations.

The bottom line, despite the fact that it is FDA-approved for migraines, stay away from butorphanol – it is only modestly effective and has many potential side effects, including addiction.

Written by
Alexander Mauskop, MD
Continue reading
March 26, 2026
Alternative Therapies
Lidocaine-Based Treatments Offer Another Option for Severe Migraines
This post explains how lidocaine, beyond its traditional use as a local anesthetic, can be given by IV or directly into the middle meningeal artery to help break severe, treatment-resistant migraines, with early studies showing promising relief and generally mild, manageable side effects.
Read article
February 16, 2026
News
Potential big news for the 40 million Americans with migraine.
It is long overue to make triptans available without a prescription, like in the rest of the world.
Read article