Aspirin is First-Line Treatment for Migraine and Episodic Tension-Type Headache Regardless of Headache Intensity

August 30, 2011

Aspirin is the first-line treatment for migraine and tension-type headaches regardless of headache intensity, according to a report published by three leading headache experts (from Austria, Germany, and Norway) in the journal Headache. Some headache expert advise using a prescription drug such as sumatriptan (Imitrex) or another triptan (Maxalt, Zomig, Relpax, etc) from the outset if the headache is severe and to use aspirin or similar drugs when the headache is less severe. However, this review of published data from large clinical trials suggests that aspirin works equally well for both moderate and severe headaches. This is true for both migraine and tension-type headaches. The six migraine trials reviewed included 2,079 patients (1165 with severe and 914 with moderate attacks) treated with 1,000 mg of aspirin and one tension-type headache trial had 325 patients (180 with moderate and 145 with severe attacks) treated with 500 mg and 1,000 mg of aspirin. Prior studies have also shown that 1,000 mg of aspirin is as effective as 100 mg of sumatriptan in the treatment of migraine headaches and aspirin had fewer side effects. Disclosure: I have patented and developed Migralex, an over-the-counter drug which contains (in 2 tablets) 1,000 mg of aspirin and 150 mg of magnesium.

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