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Should You Drive During a Migraine Episode?

Living Well

August 30, 2022

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FG Trade/Getty Images

FG Trade/Getty Images

by Susan W. Lee, DO

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Medically Reviewed by:

Susan W. Lee, DO

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by Susan W. Lee, DO

•••••

Medically Reviewed by:

Susan W. Lee, DO

•••••

•••••

Migraine is a neurological disease that causes a severe headache and other symptoms, like nausea, vomiting, and sensitivity to lights, sounds, and smells.

The head pain associated with migraine can be debilitating. It can prevent people from going to work or school and participating in their usual routine.

In an ideal world, you would not get behind the wheel of a car and drive during a migraine episode. The physical limitations and impaired thinking ability can make driving unsafe.

The reality, though, is that many people with migraine find themselves needing to get home from work, pick up a child after school, or go to the doctor’s office.

So, just how unsafe is driving with a migraine, and are there any ways to reduce the risks? Here’s what the science says about driving with migraine.

What is migraine?

While more than 10% of people worldwide experience migraine, it’s often misunderstood as just a “bad headache.” Migraine can be infrequent or chronic, occurring multiple times per week or month. Episodes can last for hours or days.

During a migraine episode, many people will have pulsing, throbbing pain on one or both sides of their head that gets worse with movement. This often forces them to retreat from their daily lives until the pain passes.

There may also be stages of migraine before and after the episode that cause:

  • brain fog
  • irritability
  • dizziness
  • extreme fatigue
  • visual disturbance
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Is it safe to drive if you have a migraine episode?

Although it can be hard to avoid driving during a migraine episode, especially if your migraine is chronic and you have frequent episodes, driving is not considered a safe activity.

Research into the effects of migraine on driving is sparse, but there are two potential issues: the neurological symptoms that occur during an episode and the side effects of any medications you may be taking to prevent or treat episodes.

When prescribing your migraine medication, your doctor or pharmacist will tell you whether any of the medications will limit you from driving.

Common medications like sumatriptan can make you dizzy or sleepy. Anti-nausea medications can make you drowsy, too.

Doctors usually recommend that you avoid driving or operating heavy machinery after taking these types of medications. In fact, one newer medication, lasmiditan, has a specific warning that you cannot drive or operate heavy machinery for at least 8 hours after taking it.

When it comes to assessing your own symptoms against your ability to drive, it can get tricky. You might feel confident in your ability to safely travel.

But the American Migraine Foundation advises people with migraine to avoid driving during any stage of a migraine episode since symptoms can get suddenly worse.

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How does migraine affect your ability to drive?

There are several migraine symptoms that can make driving an unsafe activity. Here are some of the most common ones, along with how they interfere with driving.

Nausea and vomiting

Nausea is hard enough to deal with while driving. It’s nearly impossible to keep your eyes on the road while you’re actively vomiting.

Dizziness

Dizziness is a common symptom of migraine, and one that can get worse with frequent head movements.

This type of vestibular disturbance can make driving difficult. According to a 2020 research review, many people with vestibular disorders say their symptoms limit their ability to drive.

Visual disturbances

If a migraine episode occurs with aura, you might experience visual disturbances, like:

  • flashing lights
  • seeing spots or stars
  • temporary partial loss of vision

These disturbances can affect your ability to assess your surroundings while driving.

Brain fog

Migraine episodes often involve a number of cognitive impairments, like:

  • memory loss
  • slowed or confused speech
  • difficulty concentrating

This brain fog can make it hard to navigate safely from one place to another while behind the wheel.

Sensitivity to light and sound

The cabin of a car presents increased sensitivity to light and sound. This can make it difficult to keep your eyes open, fixed on the road, and focused on your environment.

Drowsiness

Sleepiness and traffic collisions go hand in hand. Since migraine can cause extreme fatigue and drowsiness, it may be physically impossible to stay alert and awake enough while driving to keep yourself and others safe.

Weakness

This is less common, but there is a type of migraine that causes an aura involving weakness on one side of the body: hemiplegic migraine. Its symptoms often feel similar to a stroke.

If you can’t control your physical movements at any stage of a migraine episode, you can’t safely drive a vehicle.

Is it legal to drive with a migraine episode?

While it’s not the safest choice to drive during a migraine episode, it is legal to do so in all 50 U.S. states.

Unlike other neurological conditions (like epilepsy, narcolepsy, and seizure disorders), a migraine diagnosis doesn’t come with any extra steps or limitations, such as:

  • automatic restrictions
  • physician reporting requirements
  • need for a physical exam or exemption from a doctor to obtain a driver’s license

However, state laws do vary about which medications and medical conditions require licensing restrictions — and just because something is legal doesn’t mean it’s always safe.

Make sure to check with your state’s Department of Motor Vehicles (DMV) if you have questions. You can also ask your doctor whether they have concerns about your ability to drive while taking any prescribed medications.

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What to do if you have a migraine episode while driving

If a migraine episode begins or worsens while you’re behind the wheel, there are ways to mitigate the risks.

You can:

  • Pull over somewhere safe and try to wait out the worst of your symptoms by closing your eyes and resting or dozing.
  • Park your car somewhere safe and call for a ride from a friend or family member, ride-share, or taxi.
  • Drive slowly. Turn on your hazard lights or drive in the far-right lane.
  • Pull over and take any medication you have on hand, or pull over at a pharmacy for over-the-counter pain relievers. Check whether any of these drugs impair driving. If you can, ask a pharmacist.
  • Regulate your sensory input while you drive. Open the windows or turn on the air conditioning, turn off the radio, put on sunglasses, or turn down your sun visors.
  • Stop for frequent breaks. Give yourself a chance to rest.

Ultimately, if you have migraine and know that an episode is possible before or during driving, think about your options and have a plan for what you can do to manage your symptoms or avoid driving entirely.

Keep medications in the car, know where you can pull over safely along your route, and have a few people in mind whom you can call if you need a ride.

Can you prevent migraine episodes while driving?

For some people, the act of driving is a migraine trigger in itself. You might have felt fine when you left the house, but now that you’re driving on the highway — with sunlight reflecting off the windshield and the smell of exhaust fumes seeping into your car — you’re struggling.

If this sounds like you, the best strategy for avoiding migraine episodes while driving is to identify your migraine triggers.

Since migraine can come with sensitivities to lights, sounds, and smells, consider whether any of these sensory inputs are more likely to trigger an episode, and work on troubleshooting them:

  • If bright light is a trigger, consider using window films that reduce glare and wearing sunglasses designed to block a maximum amount of light. There are even some eyeglasses and sunglasses marketed toward people with migraine. (Research is lacking on whether these clinically work, but there are anecdotal reports they can help.)
  • If smells are a trigger, keeping aromatherapy tools inside your car, like essential oil diffusers, can help offset some of the smells coming from outside.
  • If sound is a trigger, there are ways to soundproof your car with foam mats or panels and weather seals to reduce noise inside the cabin. You could also listen to soothing sounds or even white noise on your car’s stereo system.

You may also want to think about migraine prevention strategies if you know you’re more susceptible to getting an episode before driving.

If you’re an infrequent driver or expect the driving or weather conditions on a particular day to be a migraine trigger, you might be able to avoid an episode by taking preventive medications before getting in the car. Just be sure they are not drugs that cause drowsiness. 

Talk with a doctor about preventive migraine medications before taking them. These drugs may have specific restrictions about how much can be taken before driving.

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When to contact a doctor

Like most other conditions, if migraine is affecting your daily functioning, it’s time to talk with a doctor.

It’s one thing to occasionally be inconvenienced by a migraine episode. But if you’re finding that migraine episodes are disrupting your ability to drive on a recurring basis and interfering with your life, don’t ignore it.

If you’re already receiving treatment for migraine but your inability to drive is a new symptom, also speak with a doctor. You could be moving from episodic migraine to chronic migraine, which requires a different treatment approach.

Takeaway

People with migraine are legally allowed to drive without restrictions, but that doesn’t mean it’s a safe choice when you’re in the middle of a migraine episode.

The physical symptoms and cognitive side effects of a migraine episode can make driving hazardous to both you and others on the road.

Avoid driving during a migraine episode as much as possible. Have a plan for what to do if an episode starts while you’re driving, or if you need to get from one place to another.

Medically reviewed on August 30, 2022

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About the author

Susan W. Lee, DO

Dr. Susan W. Lee is an ABMS board certified neurologist with fellowship training in clinical neurophysiology. She currently practices in Los Angeles, California, and her subspecialty interests include the management of epilepsy and headache disorders.

Education

  • University of California, Los Angeles, BS
  • Touro University College of Osteopathic Medicine, DO
  • St. Joseph’s Hospital & Medical Center, Internship
  • Barrow Neurological Institute, Residency
  • UCLA/Cedars Sinai Medical Center, Fellowship

Certifications

  • American Board of Psychiatry and Neurology – Neurology
  • Diplomate of the American Osteopathic Board of Neurology and Psychiatry

Professional Accomplishments

  • Super Doctors Southern California Rising Stars
  • American Epilepsy Society Top 10% Poster Presentation
  • American Epilepsy Society Investigator Award

Affiliations

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