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Keep Migraines at Bay

Ways and Means

Once you've had a migraine, you know you never want to have one again. And that should be the goal of your physician in managing your condition—migraine prophylaxis, also known as migraine prevention. Lots of times, migraine prevention involves medication, but there are other ways and means to keep the headaches at bay.

In general, neurologists feel that patients who suffer from two or more headaches a week should be placed on a prophylactic regimen to prevent the development of rebound headaches--headaches that result from the overuse of pain medications and tend to occur once a day. Rebound headaches are notorious in that they are more difficult to treat than migraines.

The truth is that even patients having fewer than two headaches a week may be good candidates for migraine prophylaxis. Your physician will assess the following factors to determine whether or not migraine prevention treatment is right for you:

Headache Frequency

Headache Severity

Length of Headaches

Response to Acute Headache Therapy

Even one or two really bad migraines in the course of a month may convince your doctor that you need migraine prevention. The tricky part of the decision is weighing which course makes better sense: taking a preventative, or treating the migraines as they occur.

Personal Migraine Triggers

Any good physician worth his salt will begin your preventative migraine regimen by helping you determine your personal migraine triggers so you can eliminate their influence on your headache health. Triggers may be not enough sleep, skipping meals, drinking coffee, or eating chocolate. These are triggers that can be controlled; however, there are other common migraine triggers that cannot be controlled by the sufferer, such as weather, the menstrual cycle, and certain stress-producing situations.

The next step is to rule out rebound headaches since these can confuse the issue. If you are taking daily pain medication and having headaches every day, it's likely you're having them. Your doctor will be right to insist you stop taking all pain medication before he will help you develop a plan for migraine prophylaxis since migraine prevention is doomed to failure, as long as you keep taking those medications.

Now comes the time for your doctor to choose a migraine prevention medication. Your doctor will probably start you on the drug with the best rate of success in preventing migraines. If your migraines don't respond, your doctor will start you on the next best candidate and so forth, until the medication is found that works for you. The four best migraine preventative medications are Elavil, Inderal, Depakote, and Topamax.