If you have migraines, you know they’re more than everyday headaches. With migraines, you may have intense pain, nausea, light sensitivity and brain fog. When you’re dealing with a migraine, you may not be able to work, go to school or manage your daily life.
Some people don’t have migraines that often, so they can treat them as they happen. But others have migraines that are frequent or severe. In those cases, preventive migraine medications may help.
Nida Laurin, MD, a neurologist with Banner - University Medicine, explained more about what preventive migraine treatment is, who it may help and what to expect.
What preventive migraine medications are
Preventive migraine medications are medicines that you take regularly, not when you’re having a migraine attack. Their purpose is to lower the number of migraines you have over time and reduce how disabling they are.
The goal isn’t to cure your migraines. It’s to improve your quality of life by making migraines less frequent, less severe or easier to manage. “They are designed to make treatment more effective when you do have a migraine,” Dr. Laurin said.
Who may benefit from preventive treatment
According to the American Headache Society Consensus Statement, you should consider prevention if:
- Attacks interfere with work, school or your daily activities even though you’re treating them as well as you can
- You have migraines six or more days a month
- You have migraines less frequently but they are disabling
A health care provider can help figure out whether prevention makes sense based on your symptoms, health history and the impact they have on your life.
Common types of preventive migraine medications
“There are multiple classes of effective preventive treatments,” Dr. Laurin said. Your provider will recommend preventive medications based on your migraine pattern, other health conditions and how your body responds.
Medications first used for other conditions
Some preventive options were originally developed to treat other conditions but also help prevent migraines. These medications work on pathways in the brain that are involved in pain and migraine activity.
- Hypertension: Beta-blockers or candesartan/lisinopril
- Obesity: Topiramate, which may also promote weight loss
- Depression and insomnia: Amitriptyline or venlafaxine
- Mood disorder or seizures: Valproates
“In these cases, we start at a low dose and gradually increase the dose based on tolerability and response,” Dr. Laurin said. However, these medications could cause side effects, such as drowsiness, appetite or weight changes, dry mouth or eyes, constipation or urinary retention, dizziness, depression or high blood sugar. So not everyone can take them.
Migraine-specific preventive medicines
“A new generation of treatments was developed specifically for migraine,” Dr. Laurin said. They are approved by the U.S. Food and Drug Administration (FDA) for adults and often used off-label for adolescents. These options are often taken as injections or infusions on a set schedule.
Your provider can explain if these options may be right for you. In many cases, your provider will want to try two other medications before trying migraine-specific medications. They may also want you to try these medications along with other preventive medications for migraines.
How long preventive medications take to work
Most preventive migraine medications don’t work right away. It often takes several weeks to several months to notice fewer migraines or milder symptoms. Your provider may have to adjust the medication gradually to balance effectiveness and side effects. Patience and follow-up visits are important.
The exception is certain migraine-specific treatments, which don’t need to be adjusted gradually. So with these medications, you may see benefits more quickly.
Possible side effects and safety
Side effects vary depending on the medication. Many are mild and improve as your body adjusts.
Your provider will weigh the benefits of migraine prevention against the risk of side effects. Don’t stop or change your medication without talking with your provider.
Other preventive migraine treatments
In addition to medication, several devices that stimulate nerves through your skin or scalp are approved for preventing migraine. “These devices have favorable safety profiles and are often used in pregnancy,” Dr. Laurin said. However, insurance may not cover these treatments.
Preventive medication is one part of migraine care
Medication works best when it’s part of a broader migraine care plan. “Migraine is a lifelong condition, but you can manage it with medications and, most importantly, lifestyle choices,” Dr. Laurin said.
You’ll probably see better results when you also focus on taking care of your mental and physical health with:
- A good diet
- Regular sleep routines
- Physical activity
- Staying well hydrated
- Managing stress
- Identifying and avoiding personal migraine triggers
When to talk to a provider about migraine prevention
Getting help early can sometimes keep migraines from getting harder to manage over time. You may want to discuss preventive treatment if:
- You’re having migraines more often
- Your headaches interfere with your daily life
- The treatments you’re trying aren’t working well
- You feel stuck or frustrated
What to expect from migraine care at Banner Health
Migraine care typically starts with a thorough evaluation of your symptoms, triggers and medical history. At Banner Health, we personalize treatment plans and adjust them over time as your needs change. Our providers work with you to adjust your medications, lifestyle strategies and follow-up care to find what works best.
If migraines are affecting your quality of life, connect with a Banner Health provider who can help you understand your preventive treatment options and create a plan that fits your needs.
