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Headache : Migraine Last Updated: Oct 6, 2009 - 12:07:30 PM

Preventive medication for migraine headache
By steve
Oct 5, 2009 - 12:32:43 PM

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Preventive Medication
Preventive or “prophylactic” medicine may help decrease how often your headaches occur, how severe they are and how long each one lasts. It is usually prescribed for people:
 
  • Who have four or more headache days each month
  • Whose abortive medicines do not consistently work
  • Who have very painful, disabling headaches that interfere with their regular daily activities and ability to work
Unlike abortive medicines, preventive medicines should be taken every day. You may need to take a preventive medicine daily for four to six weeks before you will know how effective it can be. Most preventive medications are used to treat migraine as an off-label use. While these medicines can help prevent headaches or decrease their frequency, they will not stop a headache that has already started. Never stop taking a preventive medicine suddenly. Always talk to your health care provider first.

  • Anti-convulsants  These medicines were originally used to treat seizures (convulsions or epilepsy). Now, certain anti-convulsants are also used to help prevent migraine headache. For example, valproic acid (Depakote) and topiramate (Topamax), which have been recently FDA-approved for migraine prevention. Other anti-convulsants such as gabapentin (Neurontin) are also used. 
  • Anti-depressants These medicines were originally used to treat depression and related disorders. However, headache experts have learned that these medicines can also help prevent migraine headache. Common anti-depressants used for treating migraine include:
    • Tricyclic anti-depressents (TCAs) such as amitriptyline (Elavil), nortriptyline (Pamelor) and doxepin (Sinequan)
    • Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac) and paroxetine (Paxil)
    • Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor)
       
  • Beta-blockers  These medications are commonly used to treat medical conditions such as heart arrhythmias and high blood pressure. Some beta-blockers that are effective in preventing migraine include propranolol (Inderal) and atenolol (Tenormin). 
  • Calcium channel blockers  These medicines are commonly used to treat medical conditions such as angina and high blood pressure. They are also widely used for treating migraine and cluster headaches. One example is verapamil (Calan, Isoptin).
  • Serotonin antagonists  These medications should not be taken for longer than 4 to 6 months. Although the way they work to prevent migraine is not understood, medications such as methysergide (Sansert) can be effective. Like many of the other preventive medicines, serotonin antagonists have many side effects.

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