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Your Guide to Preventing Migraines

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3 Signs It’s Time to Try Migraine Prevention Medication

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middle aged African American woman taking off glasses and pinching bridge of nose

Far from being just a bad headache, migraine is debilitating. It’s one of the top five reasons people end up in the emergency room. An estimated 38% of people living with migraine would benefit from preventative (prophylactic) medication, but less than 13% take it. Of those who do take preventative medication, the first try may not bring enough relief. Don’t give up, especially if you’ve been diagnosed with chronic migraine, in which you experience at least 15 headache days a month. Finding the right preventative treatment can be a process, but it’s worth it to get closer to the goal of being migraine-free. 

1. Your quality of life is low.

Numerous studies have shown that migraine significantly impacts quality of life. Consider how much your migraine attacks affect your ability to see these day-to-day activities through:

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

Absences and cancellations tend to come with migraine, as well as interpersonal conflict and miscommunication. You don’t need to accept a life in which you miss important moments or can’t perform as desired in your many roles.

2. Your in-the-moment migraine treatment isn’t working like you need it to.

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

Fortunately, medications that prevent migraine can reduce these attacks and stop the cycle. Preventative therapies that can help include:

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

3. Your period triggers migraine.

Migraine is more common in women than men, and the fluctuating hormones of the menstrual cycle are one reason. The first-line medication for menstrual migraines is frovatriptan (Frova), and the second line drugs are  naratriptan (Amerge) or zolmitriptan (Zomig).

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

  • Combined hormonal contraceptives in pill, patch, or vaginal ring form
  • Progesterone-only contraceptives in pill, implant, or injection form
  • Estrogen patches or gels

Have you experienced any of the signs it’s 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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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 22
View All Your Guide to Preventing Migraines Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Prevention Migraine. NHS. https://www.nhs.uk/conditions/migraine/prevention/
  2. Prophylaxis of migraine: general principles and patient acceptance. US National Library of Medicine National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646645/
  3. Migraine Headache Prophylaxis. American Family Physician. https://www.aafp.org/afp/2019/0101/p17.html