Prevent a Migraine Before It Starts

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If you get migraine headaches, you’re one of 38 million people in the U.S.—roughly 12% of the population—with firsthand experience of this particular type of head-splitting pain. Migraines can be frustrating at best and debilitating at worst. A prevention strategy, even if it doesn’t prevent 100% of your migraines, may sound pretty appealing. It’s definitely worth a try.

Identify your triggers.

Everyone has a trigger—that is, everyone is sensitive to something that can cause or hasten the onset of a migraine. See if any of these common triggers sound familiar:

  • Bright or flashing lights. The glare from the sun, or a flashing strobe light, or even the glow of a movie screen are known for triggering migraine headaches, so you may want to take steps to avoid those. If it’s your computer screen that’s giving you trouble, take frequent breaks to rest your eyes.

  • Strong odors. Tobacco smoke, your coworker’s perfume, paint thinner, car exhaust, even detergent can all be triggers.

  • Loud noises. You might not be able to control the occasional unexpected loud noise, but if you’re subjected to loud noises on a regular basis—say at work or at home--you may want to consider finding another place to work or rest.

Learn to identify your own triggers by keeping a headache diary. Write down the time of day your headache started, along with your location and what you were doing. Women might also want to track their menstrual periods, since there is a relationship between estrogen levels and migraines. You’ll soon start to recognize events and actions that seem to precede the onset of a migraine, which will help you avoid them—and hopefully avoid developing a migraine.

Avoid eating certain foods.

Just as squinting in the glare of a bright light can trigger a migraine, so can eating certain foods.  Consider taking a pass on foods like hot dogs and lunch meat that contain nitrates, a well-known trigger.  The flavor additive monosodium glutamate, or MSG, which is often found in seasonings, broths and fast food, can also be problematic. Even your diet soda or yogurt could be a trigger if it’s flavored with an aspartame—Equal or NutraSweet are common brands.

Still have that headache diary out? The next time you experience a migraine, add in any details about food or beverages you consumed in the previous 24 hours. Soon, you’ll also notice if you’ve eaten something that might have triggered your headache—and you can choose an alternate dish next time.

Stress less.

Does this sound familiar? The first thing you do when someone tells you to reduce your stress level is to stress out about how to reduce your stress level. But stress is a major trigger of migraines, so it’s worth making the effort to address it. In addition to avoiding some headaches, you may improve other aspects of your health that are influenced by stress, too.

Some strategies to try include meditation, yoga, relaxation exercises, and regular physical exercise. You might also work on getting a good night’s sleep, as sleep deprivation can definitely contribute to a higher stress level.

Try preventive medications.

When taken prophylactically, certain medications may be able to help you stave off some episodes.  Typically, your doctor might suggest one of the following:

  • Anticonvulsants. These anti-seizures meds can help, but they can have side effects in higher doses.

  • Antidepressants. Your doctor may want to try you out on an antidepressant like amitriptyline which can also help with any depression or sleep problems you may also be experiencing.

  • Beta blockers. These drugs are designed to combat high blood pressure but they can also prevent episodic migraines.

  • Angiotensin blockade drugs. Some studies have shown that the drug lisinopril, which is a drug for treating hypertension called an angiotensin-converting enzyme inhibitor (ACE inhibitor), can prevent some migraines.

  • Calcium channel blockers. Yet another type of medicine designed to combat high blood pressure and prevent your blood vessels from narrowing might help prevent the onset of a migraine.

  • Botulinum toxin. Botox injections aren’t just for wrinkles anymore. Some people find the injections reduce their migraines, too, and it’s usually well tolerated.

  • CGRP blockers. The first class of drugs developed specifically to prevent migraines, these drugs block a molecule thought to instigate and worsen episodes.

These medications all can have side effects, which you can discuss with your doctor. Some may be easier to tolerate than others. However, if you find one that’s effective enough, you may decide you’re willing to put up with the side effects. Some medications may not be appropriate for you, based on your health and any other underlying health conditions you may have.

One caveat: you probably will have to temper your expectations for success. Prevention can definitely help reduce the frequency of your migraines, but it will not cure them altogether. In fact, if a prevention strategy reduces the frequency or severity of your migraines by half, that’s considered a success, according to the American Headache Society. You will likely still have to take some sort of medication to address the acute pain, too.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jun 15

  1. Diamond ML and Marcus DA. Controversies in Headache Medicine: Migraine Prevention Diets. American Headache Society.

  2. Estemalik E and Tepper S. Preventive treatment in migraine and the new US guidelines. Neuropsychiatr Dis Treat. 2013; 9: 709–720.

  3. Migraine Prevention. Mayo Clinic.

  4. Migraine fact sheet. Office on Women’s Health. U.S. Department of Health and Human Services.

  5. Modi S and Lowder DM. Medications for Migraine Prophylaxis. American Family Physician. 2006 Jan 1;73(1):72-78.

  6. Prevention of Migraine. Headache: The Journal of Head and Face Pain. September 2013.

  7. Rapoport AM. How to Choose a Preventive Medication for Migraine. American Headache Society.

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