Explore the prophylactic treatments available for migraine and how they may help manage migraine symptoms long-term.
In medical terms, options that work to prevent migraine are also referred to as migraine prophylaxis. Some medications and treatments used as prophylactics may help reduce the frequency and severity of these headaches.
Anticonvulsant drugs, also known as antiepileptic drugs (AEDs), are medications that help treat and prevent epileptic seizures by slowing nerve signals in the brain.
Topirimate, Phenytoin, Carbamazepine, and Gabapentin are commonly used for migraine. Divalproex is used rarely, but is approved for migraine prophylaxis.
When AEDs are used for migraine prophylaxis, it’s in the form of a pill taken daily. The dose is adjusted for each individual. Common side effects include dizziness and drowsiness. Keep in mind that stopping these types of medication abruptly may trigger a seizure.
Antidepressants are medications that treat depression, anxiety, and other mental health conditions by altering the neurotransmitters in the brain.
Antidepressant medications commonly include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), as well as other medications.
When antidepressants are used for migraine prophylaxis, they are prescribed as a pill to be taken every day. These medications may cause drowsiness, and are often taken at bedtime.
Beta-blockers are medications that reduce heart rate and blood pressure by blocking the actions of the hormone adrenaline (epinephrine).
Beta-blockers, which can be nonselective, cardioselective, or third-generation, are prescribed only if a person has high blood pressure, and if it is safe based on their heart function.
Calcium channel blockers are also used to treat hypertension and one of the preventative categories used for people who can safely take a medication that lowers blood pressure.
Botulinum toxin is an injectable drug produced by the bacterium Clostridium botulinum, which temporarily weakens or paralyzes the muscles.
While Botulinum toxin is most commonly used for cosmetic purposes, it can also be used to prevent certain medical conditions, such as chronic migraine. This treatment is given as an injection, and the migraine prophylaxis effects last for several months.
In a
Results of the analysis found that Botulinum toxin was able to reduce headache frequency by roughly 2 headaches per month.
Calcitonin gene-related peptide (CGRP) therapy uses monoclonal antibodies to reduce the inflammation and pain associated with chronic migraine episodes.
| Active ingredient | Drug name | Year approved by the FDA | Drug form |
|---|---|---|---|
| erenumab | Aimovig | 2018 | self-administered subcutaneous injection |
| fremanezumab | Ajovy | 2018 | self-administered subcutaneous injection |
| galcanezumab | Emgality | 2018 | self-administered subcutaneous injection |
| rimegepant | Nurtec ODT | 2020 | tablet that dissolves on or under your tongue |
| ubrogepant | Ubrelvy | 2019 | tablet that you swallow |
| eptinezumab | Vyepti | 2020 | in-office administered IV infusion |
| atogepant | Qulipta | 2021 | tablet that you swallow |
| zavegepant | Zavzpret | 2023 | nasal spray |
Choosing the right treatment option for migraine prophylaxis is often a matter of trial and error, which can be difficult and frustrating, especially when your quality of life is negatively impacted by chronic migraine.
However, your doctor will work closely with you to help find the medication that will work for you.
Migraine prophylaxis is one of the most important treatment approaches for reducing the frequency and severity of chronic migraine episodes.
Preventive treatment options for migraine include medications such as antidepressants, anticonvulsants, beta-blockers, and more.
Talk with a doctor about which preventive treatment options are available to you.