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Too Few Get Best Migraine Drugs

Survey: Potentially Addictive Drugs Too Often Prescribed for Migraines

Migraine Prevention

Patients experiencing as many headaches as the average survey patient may also benefit from another treatment strategy: prevention.

"With five headaches a month, the average patient in this survey would be well advised to consider a preventative medication to help manage their problems with rebound and side effects and reduce their need for acute-headache medications," Penzien says.

The FDA has approved two drugs for migraine prevention: Topamax, an anticonvulsant; and Inderal, a blood-pressure-lowering medication. However, doctors often prescribe any of a number of other medications not specifically approved for migraine prevention.

"None of the migraine preventives were actually invented for prevention of migraine, but for other types of conditions," Grosberg notes. "Prescription drugs used for migraine prevention include beta-blockers, calcium-channel blockers, tricyclic antidepressants, antiseizure medications, and even Botox. Nonprescription drugs include magnesium, riboflavin, and a butterbur-root extract called Petadolex."

Headache treatment isn't simple. Patients who suffer frequent migraines should consider asking their primary care doctor for a referral to a neurologist or a headache specialist, Penzien and Grosberg suggest.

Both stress the need for more patient education -- and for a lot more doctor education.

"The sad truth is that many doctors remain to be educated about the state of the art of migraine therapy," Penzien says. "Doctors have to partner with migraine patients and educate them about their disorder and the management of that disorder. That is a role doctors aren't handling very well."


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