For anyone who endures frequent or severe migraines, preventing these painful headaches is a top concern. Experts don't know exactly what causes migraines. But they have been able to identify medications to help prevent them.
In some people, certain foods and drinks -- or components they contain -- can trigger a migraine. One well-accepted migraine trigger is tyramine.
Tyramine is a substance found naturally in some foods. It's especially found in aged and fermented foods, such as:
Some types of beer
Also, foods high in protein may contain more tyramine if:
They have been stored for a long time
They have not been kept cold enough
This treatment approach is helpful for people with frequent migraines. Medications can reduce how often migraines occur by half or more.
You may want to consider preventive medications if:
Acute treatment medications don't help or you have bothersome side effects from them.
You have frequent migraines (more than one a week).
The latest guidelines say these drugs are effective for preventing migraines:
Antiepileptic drugs. Certain antiseizure drugs are also effective for preventing migraines. These drugs may work by calming the neurons in the brain. Neuron "hyperexcitability" plays a role in migraine and epilepsy. Up to 20% of people with epilepsy also have migraine.
Beta-blockers. These drugs are commonly used to treat high blood pressure and heart disease. It's not clear how they help prevent migraines. But improving blood flow may play a role. Some beta-blockers that are effective for migraine prevention include:
Triptans for menstrual-related migraines. Triptans are commonly used for acute migraine treatment. But one triptan -- Frova -- is also helpful for preventing menstrual-related migraines. It affects serotonin levels and may also relieve pain in other ways. Several other triptans are being studied and may possibly be effective in preventing menstrual-related migraines.
Botox. Botox is a type of toxin produced by the bacteria Clostridium botulinum. It weakens or paralyzes muscles. Botox is often used to treat wrinkles. But it was also found to help some people with chronic migraines. The FDA approved Botox for the preventive treatment of chronic migraines in 2010. It is used for people who have long-term migraine headaches at least 15 days per month, with the headache lasting four hours daily or longer. It is thought that Botox inhibits the release of certain chemicals involved in the transmission of pain signals.