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.
Although painful and troublesome, most headaches are minor and can be easily treated with aspirin or another pain reliever. (Do not use aspirin in anyone under age 19 because it may increase the risk for Reye's syndrome, a potentially fatal disease.) But if your headaches are severe, recur frequently, or are accompanied by other symptoms, you need to see a health care provider.
Headaches are categorized according to their underlying causes. Common types of headaches include:
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.