Assessment and prescribed treatment for migraine, covering both acute relief and prevention.
Assessed and prescribed by a GMC-registered GP
Prescriptions sent electronically to a pharmacy
Monitoring and follow-up included where it is needed
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Migraine is chronically undertreated. Many people manage on paracetamol for years without ever being offered a triptan, and without anyone discussing prevention.
The consultation covers both: what to take during an attack, and whether a preventer is worth considering.
Acute treatment usually means a triptan, often combined with an anti-sickness medicine. Preventers are considered where attacks are frequent enough to justify daily medication.
A sudden severe headache reaching maximum intensity within seconds is a medical emergency, not a migraine. Also urgent: headache with fever and neck stiffness, headache after head injury, or new headache with weakness, confusion or visual loss.
Migraine with aura affects contraception choices. The combined pill is generally not suitable, because of stroke risk. If you have aura and take the combined pill, raise it — see contraception.
Most people are undertreated. A triptan taken early in an attack, often with an anti-sickness medicine, works considerably better than paracetamol taken late.
Triptans work best at the first sign. Waiting to see whether it develops into a bad one is the commonest reason they fail.
Using any acute painkiller more than ten to fifteen days a month causes medication-overuse headache — a headache caused by the treatment. This is extremely common and routinely missed.
If you are having attacks frequently enough, a daily preventer reduces both frequency and severity, and reduces the acute medication you need.
Triptans can cause tightness in the chest, throat or jaw, tingling and drowsiness. Overusing any acute painkiller more than ten to fifteen days a month can cause medication-overuse headache, which makes everything worse.
Triptans are not suitable with uncontrolled high blood pressure, ischaemic heart disease, or a history of stroke. Migraine with aura affects contraception choices.
A sudden severe headache reaching maximum intensity within seconds is a medical emergency — call 999.
Using any acute painkiller on more than ten to fifteen days a month causes medication-overuse headache — a headache caused by the treatment for the headache.
This is extremely common and routinely missed, and it is why a headache diary matters more than almost anything else here. It gets better when the overused medicine is withdrawn — though it worsens for a week or two first, which is why it needs planning rather than willpower.
Date, duration, severity, what you took and whether it worked, plus periods, sleep and anything obvious around it. Four to eight weeks of a diary reveals patterns nobody can reconstruct from memory, and it is what makes the next appointment useful.
Preventers need eight to twelve weeks at an adequate dose before being judged, and success means roughly halving attack frequency — not eliminating migraine, which is not usually achievable.
Most are started low and increased. Stopping at week three because nothing has changed is the commonest error.
Aura and the combined pill. Migraine with aura makes the combined pill unsuitable because of stroke risk — see contraception. Say so if you have both.
A change in pattern. New aura, a different kind of headache, or attacks becoming steadily more frequent all warrant reassessment.
Avoid codeine and combination painkillers containing it. They work poorly for migraine and are among the likeliest to cause medication-overuse headache.
Menstrual migraine is common and often missed. Attacks clustering around periods can be treated with timed treatment around that window, or by adjusting contraception — and it frequently worsens during perimenopause before improving afterwards.
Long-term codeine. Expensive supplements and devices with thin evidence. And simply enduring it — migraine is chronically undertreated, and a great many people spend years on paracetamol having never been offered a triptan or a preventer.
Almost everything used for migraine is a cheap generic — sumatriptan, propranolol, amitriptyline and anti-sickness medicines all cost very little. We earn nothing from what is prescribed.
If you have a diagnosis and simply need a triptan, ask a pharmacist first.
Migraine is treated on the NHS, and prescriptions are free in Scotland, Wales and Northern Ireland. The specialist treatments — CGRP inhibitors and Botox for chronic migraine — are hospital treatments available free through neurology, and no private prescribing service substitutes for that referral.
Lost work and family days, and years spent on paracetamol. Effective acute treatment plus prevention where warranted usually costs very little — the barrier has been access rather than price.
Very possibly, and it is the most under-recognised thing in headache medicine.
Medication-overuse headache develops from using acute painkillers too often — more than 10 days a month for triptans, codeine and combination painkillers, or 15 days for simple paracetamol or ibuprofen.
It creates a cycle: more headaches, more painkillers, more headaches. It improves when the overused medicine is withdrawn, though it worsens for a week or two first — which is why it needs a plan.
Almost certainly not. Three things to check:
Adding an anti-sickness medicine also helps, because nausea slows absorption of everything else.
Worth discussing if you have attacks on several days a month, or if acute treatment is being used close to the overuse limits.
Success means roughly halving attack frequency, not eliminating migraine — and it takes eight to twelve weeks at an adequate dose to judge. Most people who say preventers did not work stopped at week three.
Yes, and it is important. Migraine with aura makes the combined pill unsuitable because of stroke risk.
The progestogen-only pill, implant, injection and coils are all fine — see contraception. Please raise it rather than assuming somebody has checked.
Call 999 for a sudden severe headache reaching maximum intensity within seconds — that is not a migraine.
Also urgent: headache with fever and neck stiffness or a non-blanching rash; headache after a head injury; new headache with weakness, confusion, slurred speech or visual loss; a first severe headache over 50; or one much worse lying down or on coughing.
Less exotic than people expect. Skipped meals, dehydration, disrupted or excess sleep, stress — and the let-down afterwards — hormonal changes and alcohol are the common ones.
"Weekend migraine" is usually a lie-in, a late breakfast and delayed caffeine, not a mystery. A diary reveals your own patterns far better than any list.
Usually not. Migraine is diagnosed on history, and scans in typical migraine are normal and can generate incidental findings that cause anxiety and further tests.
Scanning is warranted where the pattern is atypical or has changed, or where there are neurological signs — and we will say so.
Very likely, if attacks cluster around them — menstrual migraine is common and frequently missed.
It can be treated with timed treatment around that window or by adjusting contraception, and it often worsens in perimenopause before improving afterwards.
Yes, and it is worth knowing about. CGRP inhibitors and Botox for chronic migraine are available on the NHS through neurology, and they are genuinely effective for people who have exhausted the standard options.
Referral is free. Nobody should be told nothing more can be done.
Not opioids — we do not prescribe them remotely under any circumstances, and they are a poor migraine treatment in any case: they work badly and they are among the likeliest to cause medication-overuse headache.
Triptans, anti-sickness medication and properly timed simple painkillers are the better answer, and prevention is better still.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
On this page
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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