Names: Over-the-counter painkillers include NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (the drug in the brand name Advil) and naproxen (the drug in the brand name Aleve), as well as acetaminophen (the drug in the brand name Tylenol). Aspirin is also an over-the-counter painkiller but should not be used for children younger than 15 years old. 1
How painkillers work: Painkillers, as their name suggests, stop pain. Painkillers have many different mechanisms in the body that they work through depending on the specific painkiller. In general painkillers interfere with various pain pathways and prevent a person from experiencing pain the same way they would if they did not take the medication. NSAIDs like ibuprofen and naproxen are also anti-inflammatories, which may help migraine pain in other ways, namely by reducing the hypothesized inflammation in the protective layers of the brain that is thought to cause headache pain. To learn more about why migraine pain might happen read about why migraines happen. NSAIDs are generally more effective than acetaminophen at helping stop pain for children with migraines. 2
Evidence in children: Studies have shown that painkillers, particularly ibuprofen and naproxen are effective and safe for children older than 2 years of age to use for stopping migraine headache pain. 1
Cautions: Using painkillers too often can lead to medication over-use headaches also known as rebound headaches. To avoid medication over-use headaches it is recommended that painkillers not be used more than two or three times a week unless recommended to do so by a doctor. 1 Some studies have found that naproxen is less likely to cause medication overuse headaches and may be a good choice for children with migraines.
1. Hershey, A. D. & Winner, P. K. Pediatric Migraine: Recognition and Treatment. J. Am. Osteopath. Assoc. 105, 2S-8S (2005).
2. Patniyot, I. R. & Gelfand, A. A. Acute Treatment Therapies for Pediatric Migraine: A Qualitative Systematic Review. Headache 56, 49–70 (2016).