Patients who experience regular migraines often take daily medications to prevent these headaches from occurring. This type of treatment is referred to as a migraine prophylactic regimen. A number of different medications can be used to prevent migraines, including antidepressant drugs, blood pressure pills, and anticonvulsant drugs, which are medications typically used to treat seizures. The choice of prophylactic agent often depends on the other conditions present in the affected patient. A decision to start daily prophylactic treatment for migraines depends on the severity and frequency of migraines experienced.
One class of medications used as migraine prophylactic agents are antidepressants. Taking low doses of medications such as tricyclic antidepressants on a daily basis can prevent many migraine headaches from occurring. Some tricyclic medications that can be used include amitriptyline, doxepin, and nortryptiline. Antidepressants that work by different mechanisms of action, including the drug venlafaxine, can also be used for migraine prevention.
Another drug class used as migraine prophylactic treatments are antihypertensive medications, which are usually used to treat high blood pressure. Beta blockers, calcium channel blockers, and angiotensin converting enzyme (ACE) inhibitors have all been used to prevent migraines. Using one of these drugs is particularly desirable for a patient who has both migraines and high blood pressure, since one medication could be used to treat both conditions.
Anticonvulsant medications are also used as a migraine prophylactic treatment. These medications are usually taken to prevent patients from having seizures, but they are also useful in preventing migraines. Some medications that can be used include gabapentin, topiramate, and valproate.
A number of other types of treatments have been used as migraine prophylactic options. Some alternative natural medicine options include feverfew and butterbur. Vitamins or supplements including riboflavin and coenzyme Q10 have also been given to help prevent migraines. Some research has shown that injection of botulinum toxin into specific areas of the skull can sometimes be used to treat patients who have over 15 migraines a month over at least a three month period.
Not all patients who suffer from migraine headaches need to be on a migraine prophylactic regiment. Some patients might only get migraines occasionally, and the risks associated with using a prophylactic drug might outweigh the benefits from having a reduction in migraine occurrence. Physicians and other health care providers use a number of guidelines to recommend when to start a prophylactic agent, although these rules of thumb are used in conjunction with patient preference in order to design a treatment plan. Indications for starting prophylaxis include having migraines that cause neurological defects, suffering from migraines that interfere with the ability to perform daily activities, and being unable to take medications that stop migraines after they begin.
