Preventative Migraine Medication

This page will give you a summary of the currently available preventative migraine medications, as well as links to more drug profiles.

Some of these drugs are also used to prevent cluster headache attacks. Both prescription migraine medication and over the counter drugs are listed, with a brief summary of all.

Are you looking for medication to take after a migraine attack has begun? Check this summary of abortive medicine. You can also search for a specific medication here.

There are a couple of things to remember before we begin. First, you need to discuss these treatments with a doctor who understands your medical history and knows what other medication and supplements you may be taking. We won't list all the possible side effects here, but your doctor and pharmacist can tell you what to watch for in your particular case. Second, you need to be patient! You may need to try several options before you find the preventative migraine medication for you. Many of these medications need to be used for several weeks or even months before you can tell if they're making a difference.

Preventative Migraine Medication – Beta Blockers

This category includes things like Inderal (propranolol), Blocadren (timolol), Toprol (metoprolol) and Corzide (nadolol). These drugs do a number of things. They prevent the widening of the arteries in your head by blocking the beta receptors, and they also keep the blood flowing freely by keeping the platelets in your blood vessels from clumping (platelets are responsible for blood clots).

Beta blockers can be extremely effective, but because they effect the cardiovascular system those with problems in the lungs or heart often can't take them. They also needs to be discontinued slowly.

Preventative Migraine Medication – Anticonvulsants

This includes Depakene (sodium valproate) and Depakote (divalproex sodium).  Anticonvulsants are a class of medicines used to treat seizures.  Like many preventative migraine medications, we're not 100% sure how they work to prevent headache.  It may have something to do with the way they increase levels of an amino acid known as GABA, which may play a role in migraine development.

One of today's most talked about is Topamax.  It was featured in our 21 August 2003 issue of HeadWay.  Click here for the drug migraine profile topamax.  Be sure to subscribe to HeadWay (it's free!) for more up to date info.

Preventative Migraine Medication – Methysergide

Otherwise known as Sansert or Deseril. This is one of the more toxic medications, and so is usually reserved for more serious cases. Long term use has been linked to production of fibrous tissues on the kidneys and lungs, and the thickening of cardiac valves. What that means to you is that you will need to be monitored from time to time by a doctor to ensure that this isn't happening to any great degree. You can read a profile of methysergide in the September 2005 issue of HeadWay.

Preventative Migraine Medication – Calcium Channel Blockers

This includes brand names such as Isoptin (Verapamil) and Nimotop (Nimodipine).  These medications have the ability to stop the spasm of the arteries, block the release of serotonin and inhibit platelet clumping (see Beta-blockers).  These drugs are often used to treat hypertension and some heart problems.  As with beta-blockers, patients with heart trouble may need to avoid these medicines, and they should not be stopped abruptly.  Once again a doctor will need to monitor how things are going for a while.

Preventative Migraine Medication – Antidepressants

This includes medicines such as Elavil, Sinequan, Norpramin, Prozac, Zoloft, and Paxil. Your doctor may prescribe antidepressants to you, not because you're depressed but because of your migraine attacks. It's believed that the anti-migraine effect of these medicines is a whole different reaction than what happens when treating depression. Many of them keep serotonin from being re-absorbed.

Another chemical in your head that has been linked to migraine is monoamine oxidase (MAO), and some of these drugs prevent some of MAO's actions. These antidepressants have more side effects than those mentioned above and so need to be watched closer.

Preventative Migraine Medication – Clonidine

Commonly known as Catapres, clonidine is an alpha blocker that also protects the blood vessels. Not as effective as beta-blockers, but it does seem to be of special help if you suffer a lot from migraine attacks triggered by food.

Preventative Migraine Medication – Cyproheptadine

Another drug that works to counteract serotonin as well as histamine (a protein).  It's most often prescribed to children, and seems to be only slightly effective for adults.

Preventative Migraine Medication - NSAIDs

Nonsteroidal Anti-inflammitory Drugs.  Though primarily used to stop headaches once they start, they have also been used as a preventative medication.  There are several problems with using these over the long term, such as stomach trouble and the risk of getting rebound headache.  A doctor will probably have to closely monitor you while you're on these drugs.  Quite often these drugs will be used for those with menstrual migraine.

Indomethacin (sold under brand names such as Indocin) is an NSAID often used for short term severe headaches, such as an ice pick headache.

For information on one of the most popular NSAIDs, Ibuprofen, read this article...

More on the controversial NSAID family, the cox2 inhibitors...

For more on NSAIDs check our painkillers page.

Preventative Migraine Medication - Botox

In the summer of 2003 a large clinical study gave very positive reviews to Botox as a preventative medication.  It is also being used in other ways to find migraine solutions. Because of the interest in this recent addition, we've given it it's own page!  Find out more about what Botox may be able to do for you...

Preventative Migraine Medication – Combinations

Sometimes combinations of the above types of drugs will be prescribed.  Obviously there is greater risk in this type of treatment, so once again you will be closely monitored by your doctor.  For example, if you have coexisting migraine and tension headache, you may be prescribed two different types of antidepressants, or an antidepressant and a beta-blocker.

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Special thanks to Dr. Seymour Diamond and his book Conquering Your Migraine, which includes great summaries of preventative migraine medication. If you're looking for more detailed description of what's available along with possible side effects and combination treatments, it makes a great read.