3 signs that it’s time to try migraine prevention medication


Migraines are far from just a bad headache, but are disabling. This is one of the five biggest reasons why people end up in the emergency room. It is estimated that 38% of people living with migraines will benefit from preventive (prophylactic) medication, but less than 13% take it. Of those taking preventative medication, the first attempt may not provide enough relief. Do not give up, especially if you have been diagnosed with chronic migraine, where you experience at least 15 headache days a month. Finding the right preventative treatment can be a process, but it’s worth getting closer to the goal of becoming migraine free.

Several studies have shown that migraines greatly affect quality of life. Consider how much your migraine attacks affect your ability to see these daily activities through:

  • Occupation
  • School
  • Housework
  • Family time
  • Social, recreational and leisure activities

Absences and cancellations tend to come with migraines, as well as interpersonal conflicts and miscommunication. You do not have to accept a life where you miss important moments or can not perform as desired in your many roles.

Migraine prevention medications can reduce your need for acute migraine treatments, which may not always relieve migraine pain as quickly or effectively as you would like. Although many people taking migraine prevention medications may still experience some migraine attacks, they are much less common and may be less severe. Plus, some people who frequently take acute migraine medications may develop medication-overuse headaches as a result. That’s right- by taking migraine medications too often, you can cause more migraine attacks.

Fortunately, medications that prevent migraines can reduce these seizures and stop the cycle. Preventive therapies that can help include:

  • Anticonvulsants such as topiramate (Topamax) and valproic acid (Depakote)
  • Beta-blockers such as metoprolol (Lopressor), nadolol (Corgard) and propranolol (Inderal)
  • Botulinum toxin as Botox
  • Calcium channel blockers such as diltiazem (Cardizem) and verapamil (Calan)
  • Antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl) and venlafaxine (Effexor XR)
  • CGRP inhibitors such as atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality)

Migraines are more common in women than men, and the fluctuating hormones in the menstrual cycle are one of the causes. The first-line medicine for menstrual migraine is frovatriptan (Frova), and the second-line medicine is naratriptan (Amerge) or zolmitriptan (Zomig).

Some menstrual migraines respond best to hormone therapy. How do you know if your migraine is menstruating? They tend to occur on a regular schedule, starting anywhere from two days before your period to three days after. Hormonal treatments can include:

  • Combined hormonal contraceptives in the form of pill, patch or vaginal ring
  • Contraceptives containing progesterone only in pill, implant or injection form
  • Estrogen patches or gels

Have you experienced any of the signs that it is time to try migraine prevention medication? Make an appointment with your doctor to start exploring your best first step to long-term relief.



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