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HeadWay, Issue #070 -- Should I use Preventative Medication?
July 22, 2009
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In this month's issue:

Should I use Preventative Medication?

News bits from the blog

Say what?!  Neuritis


Should I use Preventative Medication?

Preventing migraine, cluster, or various types of headache attacks is obviously something we're aiming for.  But what steps we take to do that is up for debate.  Many doctors will start you very early on preventative medication, but there are actually many options when it comes to prevention.

For example, some of the most effective ways to prevent migraine include various lifestyle changes (including diet, exercise, posture and movement therapy), avoiding triggers, and supplements and herbal treatments.  Regular therapies such as massage and mayofacial trigger point therapy can also be great for prevention.  Some types of surgery are also considered preventative.

Before you consider preventative medication...

  • How much are migraine, cluster, or headache disorders impacting your life?  Remember, this is not just a matter of pain, but also other symptoms, and the impact that the disease has on you even between attacks.  Think this over carefully before talking to your doctor.  Not everyone needs preventative medication, though others don't realize how much their symptoms are impacting their lives.
  • Consider what other preventative options there are besides medication.  Is medication the best route to go right now?  Will you try other things at the same time?  Will you try to use the medication to get things under control, then look to other options?
  • Does your doctor fully understand your medical history?  Other conditions you have?  Risks you have for other diseases?  Lifestyle and habits?
  • Is your doctor willing to look at other treatment options beyond medication?
  • Will you take abortive medication along with preventative treatment?
  • Recognize that migraine, cluster and headache disorders can be serious conditions.  Chronic illness such as migraine can get worse over time, and do damage to your body.  It's not just about making it through the next attack - it's about your long term health.

An introductions to your options...

Here are some of the more common types of preventative medications that your doctor may suggest.  You'll notice that most of these medications were developed for other conditions, but have been found to help people with migraine, and in some cases other headache disorders:
  • Beta blockers such as Inderal (propranolol), Blocadren (timolol), Toprol (metoprolol) and Corzide (nadolol).
  • Anticonvulsants (anti-seizure) including Depakene (sodium valproate) and Depakote (divalproex sodium), and Topamax (topiramate).
  • Methysergide - Sansert or Deseril.  Usually reserved for more serious cases.
  • Calcium Channel Blockers such as Isoptin (verapamil) and Nimotop (nimodipine).
  • Antidepressants of many types such as Elavil, Sinequan, Zoloft and Paxil.
  • Alpha-2 adrenergic agonists such as Catapres (clonodine) and Tenex (guanfacine)
  • Antihistamines such as Sandomigran (pizotifen) and Periactin (cyproheptadine)
  • NSAIDs (Nonsteroidal anti-inflammitory drugs) are sometimes used as preventatives, especially over the short term, though there are problems with using them long term.
  • ACE inhibitors such as Lotensin (benazepril) and Renitex (enalapril)
  • Angiotensin II receptor antagonists including Cozaar (losartan)and Avapro (irbesartan)
  • Leukotriene blockers such as Zyflo (zyleuton) and Singulair (montelukast)
  • Others: there are other options beyond these, and always new options under investigation.
This list will get you started as you look into what preventative treatment may be right for you.  This is only an introduction to some general categories, and is by no means an exhaustive list.

News bits from the blog



Say what?!  Neuritis

Neuritis refers to the inflammation of nerves.  Various types of neuritis can cause headache symptoms.  A host of things can cause neuritis, including infections, diabetes, cancer and alcoholism.

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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