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Preventive Migraine Medicine

Several types of migraine drugs can help prevent the piercing pain of migraines, including:

  • Beta-blockers such as Inderal (propanalol) and Toprol (metoprolol), which relax blood vessels
  • Calcium channel blockers such as Cardizem (dilatizem)  and verapamil, which reduce the amount of narrowing (constriction) of the blood vessels
  • Antidepressants such as amitriptyline and nortriptyline --  tricyclic antidepressants which have been shown to be effective in preventing migraines.
  • Anticonvulsants such as Depakote (valproic acid) and Topamax (topiramate) 
  • Botox (botulinum toxin), which can be injected in small quantities around the face and scalp; when it works, it can be repeated in 3 months.

Should you take daily migraine medicine? Here are some points to consider in making a decision.

Recommended Related to Migraines/Headaches

Understanding Headache Treatment

Headache treatment depends largely on determining the cause of the headache. Tension headaches can usually be treated by the use of over-the counter pain relievers such as Tylenol, Motrin, or even aspirin. When tension or stress is the cause, nondrug options may include massage to relieve muscle tension, yoga and other forms of exercise, and working less when possible.  The treatment of migraine headaches is somewhat more involved and may involve a number of different approaches to the pain. (Please...

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Consider Migraine Prevention Drugs If:

  • 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.  

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