Migraines: Should You Take Preventive Medicine?

What if you could stop a migraine before it even started? For some people, taking medicine every day can help prevent migraines and make them less painful when they do occur. These medicines may not get rid of your migraines entirely. But they can provide some relief from chronic migraine pain.

You may benefit from taking a preventive migraine medicine if you: 

• Have 2 or more migraines a month that keep you from your work or activities for 3 or more days per month

• Have migraines that don't respond to other medicines or you can't take other medicine for acute treatment

• Have frequent attacks (more than 1 a week) 

• Use a medicine such as a triptan or ergotamine more than twice a week to stop migraines

• Have migraines with a prolonged aura 

• Have been diagnosed with a severe type of migraine, such as a hemiplegic migraine 

• Have a long-term history of frequent, excessive use of pain medicine or use acute medicines that make headaches worse

• Have menstrual migraines

These are just general guidelines. If you think that preventive medicine could help you, talk with your healthcare provider. Nonmedicine therapies to prevent migraines should be tried first. These include exercise, relaxation techniques, and a regular sleep schedule.   

Many options available

Many different types of medicines can help prevent migraine. Some of the most common include:

• Antiseizure medicines

• Beta-blockers 

• Calcium channel blockers 

• Hormone replacement therapy

• Tricyclic antidepressants 

• Botulinum toxin

• Antibody therapy that attacks inflammatory proteins

Your healthcare provider will talk with you about which kind of medicine might be best based on your health history. It's especially important to discuss side effects of each treatment, both short- and long-term, interactions with other medicines, medicine overuse headaches (rebound headaches), as well as possible withdrawal symptoms when you stop the medicine.

Starting preventive therapy

When you start a preventive medicine, your provider will most likely start you off on a low dose and slowly increase it if needed. This will help limit side effects as your body gets used to the medicine. If you have any abnormal or unpleasant side effects, tell your healthcare provider. You may be able to take a different preventive medicine. 

It may take up to 3 months for preventive medicines to help ease migraines. Keeping a headache diary before and after starting treatment may help you keep track of how well the medicine is working. If you don't notice an improvement, let your healthcare provider know. It's also important to talk with your provider before stopping a medicine. If you stop taking these types of medicines suddenly, you may have more headaches or other side effects.