The first step to preventing migraines is to avoid triggers. These often include:
- High blood pressure
- Hormonal birth control pills
- Bending over
- High altitude
- Low blood sugar
- Excessive heat
Medications can also prevent ocular migraines. Calcium-channel blockers, such as Cardene and Calan, are the most commonly used drugs. They work by opening up the blood vessels. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin are also sometimes used. Less often, your doctor may prescribe drugs used to prevent blood clotting, depression and epilepsy.
If you don’t respond to other treatments and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You can take these regularly to reduce the severity or frequency of the headaches. These include seizure medicines, blood pressure medicines (like beta blockers and calcium channel blockers), and some antidepressants. CGRP inhibitors are a new class of preventive medicine that your doctor may recommend if other medicines don’t help.
A device is also an option. Cefaly is a portable headband-like device used for preventing migraines. It gives electrical impulses on the skin at the forehead and stimulates a nerve associated with migraine headaches. Cefaly is used once a day for 20 minutes, and when it's on you'll likely feel a tingling or massaging sensation. SpringTM may be another option. You hold this device at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain. In addition, there is a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve's fibers to relieve pain.