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.
People with frequent or severe migraine attacks can sometimes help prevent migraines if they:
Adopt lifestyle changes
Avoid migraine triggers
Use preventive medications or devices
You have moderate-to-severe headache pain that is disabling and interfering with your life despite treatment
You have at least three moderate-to-severe headache days per month
Your migraines are seriously affecting your quality of life
You are taking migraine painkillers very frequently
Your current migraine drugs are not providing sufficient relief
You are having side effects from current headache drugs
You prefer to take a preventive approach
You don't mind taking a daily medication
You have uncommon migraine conditions, like prolonged aura
Migraine Prevention Drugs Are Usually Not Used If:
You have mild-to-moderate pain that is not disabling
You have less than three moderate-to-severe headache days per month
Your headaches are controlled by drugs like NSAIDS (anti-inflammatories like Aleve or Motrin) or triptans
You don't have side effects from those drugs
You don't take those drugs frequently
You're not ready to take a daily migraine medication
You have other health conditions that do not allow you to take preventive drugs
You cannot tolerate side effects of preventive drugs
There might be negative drug interactions with other medications you are taking
You prefer a non-drug treatment (like biofeedback)
If you can't take medication or prefer not to, a device may be worth considering. Cefaly is the first FDA-approved device for preventing migraines in people over age 18. The portable headband-like device gives electrical impulses on the skin at the forehead. This stimulates a nerve associated with migraine headaches. Cefaly is used once a day for 20 minutes, and when it's on you'll feel a tingling or massaging sensation.
Migraine Drugs and Pregnancy
If you are pregnant or want to get pregnant, here's good news: Your migraines will likely ease up during the second and third trimester of pregnancy.
However, if you have severe migraines, doctors may advise first trying a non-drug approach such as biofeedback, relaxation therapy, or stress-management training . Or your doctor may suggest trying those approaches along with a preventive drug therapy that has the lowest risk possible.
Talk to your doctor about your thoughts on taking preventive medications for migraines. Together, you can decide the best approach for your headache problems.
American Academy of Neurology: Evidence-Based Guidelines for Migraine Headache.
George R. Nissan, DO, director of research, Diamond Headache Clinic, Chicago.
News release, FDA.
Richard Senelick, MD on August 29, 2012
This tool provides general information and
recommendations, and may not address specific individual circumstances. Do not
rely on it exclusively to make decisions about your health. Always consult your
doctor for personal medical advice.