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.