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Conditions
Migraine
A neurological condition causing intense, throbbing headaches often accompanied by nausea, sensitivity to light and sound, and visual disturbances.
Check online review fit
Online care is not suitable for every situation. A doctor decides what fits after assessment.
Symptoms
CommonsymptomsofMigraine
Symptoms can overlap across conditions. A doctor considers context, red flags, and whether remote review is appropriate.
Intense throbbing headache (often one-sided)
Nausea and vomiting
Sensitivity to light (photophobia)
Sensitivity to sound (phonophobia)
Visual disturbances (aura)
Dizziness
Fatigue before and after attack
Our Scope
Whereonlinereviewmayfit
Online review can help with some straightforward situations, but it is not a substitute for urgent care, physical examination, or ongoing GP management.
May fit online review
- Medical certificates for migraine attacks
- Review of current migraine management
- Discussion of preventive options
- Referral recommendations if needed
Needs in-person or urgent care
- Emergency assessment for new severe headaches
- Specialist procedures like Botox injections
- In-person neurological examination
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1Migraines becoming more frequent
- 2Current medications not working
- 3Migraines affecting work or quality of life
- 4New or different headache pattern
- 5You need a medical certificate
Seek emergency care if
- Sudden, severe headache ('thunderclap')
- Headache with fever and stiff neck
- Headache after head injury
- Headache with confusion or weakness
- First migraine over age 50
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonMigraine
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Migraines are a neurological condition, not just a bad headache, and this distinction matters for both treatment and workplace legitimacy. A true migraine involves changes in brain chemistry and blood flow that can produce visual disturbances (aura), nausea, and extreme sensitivity to light and sound - making work genuinely impossible for many people during an attack. When I assess someone for a migraine-related certificate, I am looking at the pattern: how frequent, how severe, whether their current management is adequate. If someone is having more than 4 migraine days per month, they should be discussing preventive treatment with their regular GP. Telehealth is well-suited for migraine management discussions because the diagnosis is primarily history-based - we do not need to examine you during an attack. Triptans (prescription migraine-specific medications) can be life-changing for people who have been relying on paracetamol and ibuprofen alone.
Treatment
TreatingMigraine
Migraine treatment is divided into acute therapy (stopping an attack) and preventive therapy (reducing frequency). Early treatment at the first sign of a migraine is critical -- delayed dosing is significantly less effective. For frequent migraines (4+ days per month), preventive medication should be considered.
Sumatriptan
Imigran, Suvalan
Class:Triptan (5-HT1B/1D agonist)
Typical dose:50-100mg orally at onset, may repeat after 2 hours (max 300mg/24h)
PBS:PBS listed for acute migraine treatment
- Gold standard acute migraine treatment
- Take at the first sign of headache phase (not during aura)
- Available as tablet, nasal spray, or injection
- Contraindicated in uncontrolled hypertension and cardiovascular disease
Rizatriptan
Maxalt
Class:Triptan (5-HT1B/1D agonist)
Typical dose:10mg orally at onset, may repeat after 2 hours (max 20mg/24h)
PBS:PBS listed for acute migraine
- Fastest-acting oral triptan (onset within 30 minutes)
- Available as wafer that dissolves on the tongue (good if nauseated)
- Dose reduction needed if taking propranolol
- Similar contraindications to sumatriptan
Propranolol
Inderal, Deralin
Class:Beta-blocker (migraine preventive)
Typical dose:40-160mg daily in divided doses
PBS:PBS listed for migraine prophylaxis
- First-line preventive medication for frequent migraines
- Takes 4-6 weeks to see full benefit
- Also helps with anxiety symptoms that often co-occur with migraine
- Not suitable for asthma patients
Source: Therapeutic Guidelines - Neurology, 2024. This information is educational only and does not replace clinical assessment.
Specialist referral: Referral to a neurologist is recommended if migraines do not respond to two or more preventive medications, if you experience atypical aura symptoms, if migraine frequency is increasing despite treatment, or if you have chronic daily headache.
Migraine in Australia
Migraines affect approximately 4.9 million Australians - about 20% of the population
Women are 3 times more likely to experience migraines than men
Migraines cost the Australian economy an estimated $35.7 billion annually in lost productivity
The average migraine sufferer loses 4-6 workdays per year due to attacks
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
An individual migraine attack typically lasts 4-72 hours. Most people feel significantly better within 24 hours with appropriate treatment. A 'postdrome' (migraine hangover) of fatigue and difficulty concentrating can last another 1-2 days.
Return to work
Most people can return to work the day after a migraine resolves, though some experience lingering fatigue. If your work involves screens, bright lights, or noisy environments, you may need a quieter transition day. Chronic migraine sufferers may benefit from workplace adjustments like screen filters and flexible scheduling.
When to reassess
Seek urgent care for a sudden, severe headache unlike any you have experienced before ('thunderclap headache'), a headache with fever and stiff neck, or any headache following head trauma. See your regular GP if migraines are becoming more frequent, lasting longer, or not responding to your usual treatment.
Self-Care
ManagingMigraineathome
Evidence-based tips to support your recovery alongside medical treatment.
At the first sign of a migraine, take medication immediately - early treatment is more effective
Rest in a cool, dark, quiet room during an attack
Apply a cold compress to the forehead or back of the neck
Stay hydrated - dehydration is a common trigger and worsens symptoms
Keep a migraine diary to identify your personal triggers (food, sleep, stress, weather, hormones)
Maintain regular sleep and meal schedules - skipping meals and irregular sleep are major triggers
FAQ
CommonquestionsaboutMigraine
Answers to the most common questions from patients.
Yes. Migraines can be debilitating and are a valid reason for a medical certificate. Our doctors understand that migraines can make work impossible.
Common strategies include identifying and avoiding triggers, maintaining regular sleep and meal patterns, staying hydrated, and in some cases, preventive medications.
Common triggers include stress, lack of sleep, certain foods (aged cheese, alcohol, processed foods), hormonal changes, bright lights, and weather changes.
Preventive medication is typically considered if you have 4 or more migraine days per month, if migraines significantly impact your life, or if acute treatments aren't working well.
Where online review may fit for Migraine
Remote review is not suitable for every situation. A doctor reviews the information and decides whether online care is appropriate.
Full refund if the doctor declines.