100 Migraine Drugs, A to Z: butorphanol

Butorphanol nasal spray (Stadol NS) is approved by the FDA for the treatment of acute migraine attacks. It belongs to the agonist-antagonist type of opioid (narcotic) drugs, while morphine, methadone, oxycodone, and most other opioids are pure agonist drugs. The agonist-antagonist drugs were originally thought to be less addictive, but unfortunately this is not the case.

Also, opioid analgesics despite being very strong pain killers, are not very effective for the treatment of migraines. This is in part due to the fact that migraine pain is accompanied by nausea (and other symptoms), while opioids tend to cause nausea or make it worse. Other side effects of butorphanol include constipation, upset stomach, dizziness, drowsiness, feeling strange or even having frank hallucinations.

The bottom line, despite the fact that it is FDA-approved for migraines, stay away from butorphanol – it is only modestly effective and has many potential side effects, including addiction.