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Migraines & Headaches Health Center

Migraine Guidelines Focus on Prevention

Key Medications Listed to Help Prevent Migraine Headaches
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Do You Need Migraine Prevention Treatment? continued...

"See a headache specialist if your headaches are frequent, disabling, and/or you are not doing well with other treatments," he says.

Robert Duarte, MD, is the director of the Pain Center at the Cushing Neuroscience Institute of the North Shore-LIJ Health System in Manhasset, N.Y. He says many people hesitate to take medications because they want to avoid the side effects that come with taking medication every day. "Taking preventive migraine medication that has been shown to reduce frequency and intensity of headaches will result in less dysfunction," he says. "These benefits often outweigh any risks."

That is not the only reason, says Richard B. Lipton, MD. He is the director of the Montefiore Headache Center in New York City. "Many people with migraine don't think of it as a treatable medical disorder," he says. "They don't consult doctors and don't know that what they have is a migraine problem."

Others don't think that they will benefit from prevention. That said, not all people with migraine headache need to take preventive treatments.

If you have, or think you have, migraine headaches, the first step is to see a specialist and get a proper diagnosis, Lipton says. Treatment will depend on the frequency and severity of your headaches.

"Some people have one migraine a month, take over-the-counter medication, and can return to their usual activities," he says. "Others might have 10 headache days a month that are disabling on five or six days, and they almost certainly need prevention and effective treatments for when they do get a headache."

Learning what triggers your migraine headache and taking steps to avoid those triggers also helps, he says.

Buyer Beware of Butterbur

The new guidelines support the use of the herb butterbur. But if the herb is not extracted properly then the drug isn't safe, Lipton says. Choose a well-known brand, and follow the dosing instructions on the label.

Some butterbur products may contain pyrrolizidine alkaloids (PAs). PAs can damage the liver, lungs, and blood circulation, and possibly cause cancer. Butterbur products that contain PAs are unsafe when taken by mouth.

Exactly how butterbur may stave off migraine headache is not clear, but it may have anti-inflammatory properties like NSAIDs.

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