Migraine Headache Preventive Therapy

This type of treatment is considered for persons whose migraine headaches are frequent and/or severe enough to significantly alter their lifestyle. Physicians decide whether to start a migraine preventive medication on a case-by-case basis in consultation with their patients. Preventive medications are given on a regular schedule in order to decrease the severity and/or frequency of attacks. Preventive medications must be taken on a daily basis, even if the migraineur is not experiencing headaches every day. These drugs may take up to 3 months to significantly alter the frequency and severity of migraine headaches. In other words, a specific preventive medication cannot be considered a "failure" until it has been taken as prescribed for at least 3 months to little or no effect. The following medications are some of those used in migraine headache preventive therapies:

• Beta-blockers (also used to treat high blood pressure) such as propranolol (Inderal)
  
  
• Calcium channel blockers (also used to treat high blood pressure) such as verapamil (Calan, Isoptin)
  
  
• Serotonin modifiers such as fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and citalopram (Celexa) - these are relatively ineffective compared with those in the older tricyclic class of antidepressants (for example, amitriptyline [Elavil] and nortriptyline [Aventyl])
  
  
• Antiseizure medications like gabapentin (Neurontin), valproic acid (Depakote), and carbamazepine (Tegretol)