There are many preventive migraine drugs available. Some examples include angiotensin converting enzyme (ACE) inhibitors, anticonvulsants, beta blockers, and calcium channel blockers.
Not every medication is right for every person, so individuals should always speak to a doctor to determine which migraine prevention method is best for their needs.
The following article discusses some medications for migraine prevention, their benefits, and more.
ACE inhibitors help relax blood vessels and veins. This can help lower blood pressure, which can be helpful in preventing migraines.
However, these drugs may not be the best choice for preventing migraines.
According to a 2019 study review, ACE inhibitors can be effective in reducing the number or frequency of headaches in people with migraines. However, due to the limited number of studies and small sample sizes, they may not be a good first choice for migraine prevention.
However, the review also notes that people with comorbidities like high blood pressure may find it helpful as a first or second line of treatment for migraine prevention.
Find out more about ACE inhibitors here.
Doctors usually prescribe anticonvulsants or anti-epileptic drugs to people with epilepsy. Researchers believe these drugs can work by reducing or calming down activity in the brain.
According to the American Migraine Foundation (AMF), doctors often prescribe these drugs to help prevent migraines.
A 2016 study suggests that both topiramate and divalproex sodium can help with migraine prevention. However, researchers do not fully understand how to prevent migraine episodes.
The study notes that while doctors can use these drugs as a first or second treatment option, consider the potential side effects and whether or not a person has other medical conditions before prescribing anticonvulsants for migraine prevention.
Beta blockers are a type of medication that doctors usually prescribe for high blood pressure. People with migraines who also have high blood pressure or another condition that increases their blood pressure may find beta-blockers helpful in preventing migraines.
Some research suggests that beta blockers like propranolol are effective in preventing episodic migraines due to their antihypertensive effects. They can also help with chronic migraines or tension headaches, but there is less evidence to support this claim.
In a 2019 study, researchers found that propranolol and metoprolol could both help reduce the frequency of migraine headaches.
Learn more about beta blockers here.
Doctors usually prescribe calcium channel blockers to help with heart conditions such as high blood pressure.
These drugs change the way calcium ions move in the blood vessels, which can prevent the vascular changes. By preventing the blood vessels from changing, calcium channel blockers can help prevent migraines or cluster headaches.
According to the National Headache Foundation, the Food and Drug Administration (FDA) has not approved calcium channel blockers for use in migraine prevention. However, a person with heart problems may find that these drugs can help with both conditions.
Learn more about calcium channel blockers here.
According to a 2019 review, calcitonin gene-related peptide (CGRP) plays a crucial role in migraines. CGRP increases during an episode. CGRP-blocking drugs like Aimovig can help prevent CGRP from building up, which can reduce the frequency of migraine headaches each month.
The review authors also find that CGRP-blocking drugs are generally safe and effective in preventing migraines for most people.
According to the AMF, the FDA approved CGRP drugs for the first time in 2018. She notes that a person who normally has several severe migraine headaches each month can see a significant improvement in the number of headache-free days per month and year.
Neuromodulation devices can relieve migraines by increasing or decreasing activity in the nervous system. These devices work by delivering electrical or pharmaceutical stimulation to the nerves.
A doctor may prescribe the use of a neuromodulation device to both prevent and treat migraine episodes. Most of the devices available require a prescription, but the FDA has approved one for over-the-counter use.
According to the AMF, these devices are a suitable choice for people who cannot tolerate migraine medications or who cannot take certain medications due to other health concerns. However, as with other interventions, this option may not work for everyone.
Supplements can refer to minerals, vitamins, and other substances. People usually take these to promote their overall health or to fill nutritional gaps in their diet.
Although some people use dietary supplements to treat migraines, there is limited evidence that they are helpful for this purpose.
In an older study from 2009, researchers found that dietary supplements containing one or more of the following can help people manage migraines:
- Alpha lipoic acid
- Petasites hybridus
- Coenzyme Q10
However, to avoid possible interactions, a person should speak to a doctor before taking a new supplement – especially if they are already taking other supplements or medications.
Doctors often prescribe tricyclic antidepressants to treat depression. However, these drugs can also be effective in treating migraines.
Tricyclic antidepressants like amitriptyline work by changing the levels of chemicals in the brain. This type of antidepressant may be more effective than other antidepressants at treating migraines.
However, research from 2017 suggests that while tricyclic antidepressants can be effective, people often cannot tolerate them well. The review also notes that people who took certain types of tricyclic antidepressants, including amitriptyline, were more likely to stop their treatment because of side effects.
Doctors sometimes prescribe selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) to help prevent migraines.
Doctors usually prescribe these drugs for depression. They work by affecting the levels of certain chemicals, such as serotonin, in the brain.
However, according to a 2015 study review, researchers do not recommend the use of SSRIs and SNRIs to treat or prevent migraines. The authors found that most of the studies showed that the drugs were no more effective than placebos at preventing migraines.
Learn more about SSRIs and SNRIs here.
People don’t always tolerate migraine medication well. A person living with migraines may have difficulty finding a drug or combination of drugs that are effective in preventing migraines.
As a result, they may turn to other therapies that can help with migraine prevention. These other therapies can include the following.
In 2010, the FDA approved the use of botox to treat chronic migraines. Botox blocks the nerves and pain receptors near the injection site.
The injections are approved for use in adults over the age of 18 who have more than 15 migraine headaches each month.
Find out more about botox here.
Regular acupuncture sessions can help reduce the frequency of migraine headaches.
According to a 2017 study review, regular full-body acupuncture treatment can effectively reduce the number of headaches that occur each month.
Learn more about acupuncture here.
Some research suggests that keeping a food diary may help a person reduce their exposure to migraine food triggers. People can use a food journal to keep track of what they eat and when they get a migraine headache.
According to the AMF, other anecdotal treatments – like essential oils – may not be effective. Before using any supplements or other natural remedies, a person should discuss their plans with a doctor to ensure that they do not interfere with their other medications.
Find out more about natural remedies for migraine relief here.
Many migraine prevention drugs require a prescription, which means a person must first discuss them with a doctor. A person should work with a doctor or neurologist to determine which drug or combination of drugs is best for them.
Some factors to consider are:
- other conditions a person may have
- other drugs the person is taking
- Treatment costs
- possible benefits
- possible side effects
Most migraine prevention medications require a prescription. In other words, a person needs a prescription from a doctor in order to gain access to a drug.
Doctors can recommend a number of possible migraine prevention options. The choice of medication may depend on whether or not a person is experiencing side effects, the effectiveness of the medication, other medical conditions the person is having, and any other medications the person is taking.
A person should work with a doctor to determine the best medication for them.