migraine symptoms

Know the 4 stages of migraine headaches

While everyone experiences migraines in different ways, there are 4 general migraine symptom stages. Learning to recognize these stages can help you understand what to expect—and help your family, friends, and colleagues better cope—when an attack occurs.

Stage 1: Preheadache (also called prodrome)

Migraine symptoms often begin hours or days before migraine pain. Early symptoms may include

  • Fatigue or other changes in behavior
  • Mood changes
  • Food cravings
  • Gastrointestinal problems
  • Sensitivity to light or sound

What you can do

Stage 2: Migraine aura

Aura typically begins 20 to 60 minutes before the headache phase (stage 3) and usually fades before the headache begins. Sufferers may experience visual symptoms such as

  • Flashing lights
  • Zigzag lines
  • Blank spots before their eyes

What you can do

  • Keep your migraine medication handy—the earlier you take your medication the more effective it may be
  • Implement your plan of action and inform family, friends, and work
  • Find a quiet, dark room to relax

Stage 3: Headache

Debilitating head pain that may be accompanied by nausea and vomiting:

  • The pain can last from 4 hours to as long as 72 hours
  • Most people feel pain on one side of the head or the other; however, it’s not uncommon to feel it on both sides

What you can do

  • Keep your migraine medication handy—the earlier you take your medication the more effective it may be
  • Avoid unnecessary activity
  • Find a quiet, dark room to relax

Stage 4: Postheadache (also called postdrome)

The period following the headache. Some sufferers may experience one or more of the following

  • Fatigue
  • Depression
  • Feelings of euphoria
  • Intense well-being

What you can do

  • Make notes about your migraine attack and possible triggers in your migraine diary (PDF — 239KB)
  • Review your migraine plan of action and make any necessary adjustments
  • Thank the people who helped while your headache was at its worst
  • Keep your migraine medication handy in case the headache returns

Important Safety Information

ZOMIG is a prescription medication used for the treatment of migraine headaches in adults.
ZOMIG is not for the prevention of migraines.

  • Do not take ZOMIG if your headache is not a migraine
  • Do not take ZOMIG if your headache is hemiplegic or basilar migraine (If you are unsure about this, ask your doctor)
  • Do not take ZOMIG if you have heart disease, history of, or risk factors for heart disease, uncontrolled high blood pressure, circulation (blood flow) problems, or have had a stroke. Only your doctor can determine if ZOMIG is right for you
  • ZOMIG should not be used within 24 hours of another 5-HT1 agonist (triptans), ergotamine-containing or ergot-type medication (for headache), or within 2 weeks of an MAO-A inhibitor (for depression)
  • Talk to your doctor if you are pregnant, planning to become pregnant, or breastfeeding because ZOMIG may not be right for you
  • ZOMIG, like other triptans, may be associated with a potentially life-threatening condition called serotonin syndrome, mainly when taken together with certain antidepressants. Inform your doctor of all your medications prior to taking ZOMIG
  • Phenylketonurics: ZOMIG-ZMT® (zolmitriptan) Orally Disintegrating Tablets contain phenylalanine, a component of aspartame
  • Safety and effectiveness of ZOMIG in pediatric patients have not been established
  • Side Effects: The most common side effects reported by patients in clinical trials with ZOMIG Nasal Spray include unusual taste, tingling sensation, skin sensitivity, and dizziness
  • Side Effects: The most common side effects reported by patients in clinical trials with ZOMIG Tablets and ZOMIG-ZMT include dizziness; tightness, pressure, pain in the neck, throat, or jaw; fatigue; tingling; drowsiness; and nausea

Talk to your doctor about prescription ZOMIG.

Read the full Prescribing Information for ZOMIG Nasal Spray (PDF — 122KB)

Read the full Prescribing Information for ZOMIG Tablets and ZOMIG-ZMT (PDF — 194KB)

Read the Consumer Friendly Brief Summary (PDF — 480KB)

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.