Migraine Prevention

Migraine can be treated at the onset of each headache with appropriate medications. There is some evidence that those who have frequently occurring migraines may have fewer migraines if they take a preventative treatment or alter their lifestyle.

Medications that reduce migraine frequency

• Beta Blockers: unless contraindicated, beta blockers are considered the first line for migraine prevention. Asthma and perhaps depression are the most common reasons to avoid beta blockers.
• Amitriptyine: the next best treatment to beta blockers, amitriptyline is frequently used in combination with a beta blocker. The combination therapy actually has less side effects than either alone, as the medications play off each other. For example, amitriptyline produces increased heart rate while beta blockers reduce heart rate.
• Anti-epilepsy drugs: Depakote ER, gabapentin and topirimate are all useful, but each has side effects. These are the next prescription agents to try
• Calcium channel blockers: Calan (and for some others such as diltiazem) may be helpful in those who do not respond to the first line treatments.

Medications that Increase Migraine Frequency

• Narcotics: this class of medications, when taken regularly, increases the number of endorphan receptors in the brain. The body will be unable to produce enough endorphans to fill the receptors. This means that a person taking narcotics on a daily basis will actually experience more pain. Headache frequency, duration and severity wil increase.
• Ergotamines: this class of medications can lead to inflammation of blood vessels, with the result of increased headaches.