First, preventive, or prophylactic, medications are prescribed to prevent or reduce the number of attacks in patients who experience frequent Migraines, typically two or more per month. In general, these medications act over time to prevent blood-vessel swelling; however, they do not treat the Migraine-associated symptoms and are non-selective. Many sufferers using preventive treatments will still have to take attack-aborting medications to relieve pain and other symptoms.
Beta-blockers Cardiovascular drugs are the most commonly prescribed prophylactic treatment for Migraine and are considered to be an effective preventive treatment. Medication includes propranolol. Click here for more detailed information. These drugs are considered among first-line treatment agents. Calcium channel blockers, another class of cardiovascular drugs, especially verapamil (Calan, Isoptin), also may be helpful. In addition, the antihypertensive medications lisinopril (Prinivil, Zestril) and candesartan (Atacand) are useful migraine prevention medications. Researchers don't understand exactly why all of these cardiovascular drugs prevent migraines. Side effects can include dizziness, drowsiness or lightheadedness.
Antidepressants are believed to have a possible effect on serotonin or possible analgesic effects. These medications are considered among first-line treatment agents and may reduce migraines by affecting the level of serotonin and other brain chemicals. You don't have to have depression to benefit from these drugs. Newer antidepressants, however, generally aren't as effective for migraine prevention.
Calcium channel blockers are also used to decrease the frequency of Migraine attacks. It is thought that calcium channel blockers play a role in vessel constriction. Click here for more detailed information.
Methysergide is thought to block the inflammatory and vessel-constricting effects of serotonin. Because of potential side-effects, methysergide is generally used only on select patients. This medication also requires a four to six week drug hiatus every six months. Click here for more detailed information.
Divalproex Sodium (Depakote®) is probably the most promising of the preventive regiments currently available for Migraine. This drug was originally developed for Epilepsy; a disease often referred to as a sister disorder to Migraine, prescribed in much smaller doses when used to treat Migraine thus lessening the mild side effects.
Anti-seizure drugs. Although the reason is unclear, some anti-seizure drugs, such as divalproex sodium (Depakote) and topiramate (Topamax), which are used to treat epilepsy and bipolar disease, seem to prevent migraines. Gabapentin (Neurontin), another anti-seizure medication, is considered a second-line treatment agent. In high doses, however, these anti-seizure drugs may cause side effects, such as nausea and vomiting, diarrhea, cramps, hair loss and dizziness.
Cyproheptadine. This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
Botulinum toxin type A (Botox). Some people receiving Botox injections for their facial wrinkles have noted improvement of their headaches. The mechanism by which Botox might prevent migraines is unclear, although the drug may cause changes in your nervous system that modify your tendency to develop migraines. Studies using Botox injections for migraines have had mixed results. Additional research is necessary. Still, if several other preventive medications have failed to control your headaches, you might talk to your doctor about trying Botox.
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