Preventive medications

Preventive medications can reduce the frequency, severity and length of migraines and may increase the effectiveness of symptom-relieving medicines used during migraine attacks. Your doctor may recommend that you take preventive medications daily, or only when a predictable trigger, such as menstruation, is approaching.

In most cases, preventive medications don't eliminate headaches completely, and some can have serious side effects. For best results, take these medications as your doctor recommends:

Cardiovascular drugs. Beta blockers — which are commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines. 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. Certain antidepressants are good at helping prevent all types of headaches, including migraines. Most effective are tricyclic antidepressants, such as amitriptyline, nortriptyline (Pamelor) and protriptyline (Vivactil). 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.

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.

Migraine has no cure

Migraine is a medical condition. Most people who suffer from migraines get headaches that can be quite severe. A migraine headache is usually an intense, throbbing pain on one, or sometimes, both sides of the head. Most people with migraine headache feel the pain in the temples or behind one eye or ear, although any part of the head can be involved. Besides pain, migraine also can cause nausea and vomiting and sensitivity to light and sound. Migraine can occur any time of the day, though it often starts in the morning. The pain can last a few hours or up to one or two days. Some people get migraines once or twice a week. But migraine attacks can interfere with your day-to-day life.
We don’t know what causes migraine, but some things are more common in people who have them:

• Most often, migraine affects people between the ages of 15 and 55.
• Most people have a family history of migraine or of disabling headache.
• They are more common in women.
• Migraine often becomes less severe and less frequent with age.

Most researchers think that migraine is due to abnormal changes in levels of substances that are naturally produced in the brain. When the levels of these substances increase, they can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.
If you get migraine headaches, talk with your doctor. Before your appointment, write down:

• how often you have headaches
• where the pain is
• how long the headaches last
• when the headaches happen, such as during your period
• other symptoms, such as nausea or blind spots
• any family history of migraine
• all the medicines that you are taking for all your medical problems, even the over-the-counter medicines
• all the medicines you have taken in the past that you can recall and, if possible, the doses you took and any side effects you had

Migraine has no cure. But your migraines can be managed with your doctor’s help. Together, you will find ways to treat migraine symptoms when they happen, as well as ways to help make your migraines less frequent and severe. Your treatment plan may include some or all of these methods.
Medicine. There are two ways to approach the treatment of migraines with drugs: stopping a migraine in progress (called “abortive” or “acute” treatment) and prevention. Many people with migraine use both forms of treatment.
Acute treatment. Over-the-counter pain-relief drugs such as aspirin, acetaminophen, or NSAIDs (nonsteroidal anti-inflammatory drugs) like Ibuprofen, Naproxen relieve mild migraine pain for some people. These two drugs decrease symptoms, but must not be take more than two times per week as return headaches may occur. Though, if headaches happen more often than twice a week, then must be applied therapy .