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Treating with Preventive Migraine Medication

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Once you or your primary care physician has decided that your headaches warrant a neurological exam you might as well see a doctor who is familiar with migraine headache treatment as well as the medications used for migraine prophylaxis or migraine prevention. Do your homework and get some recommendations before you make an appointment for a consultation. An important part of migraine treatment is the ability of the doctor to listen to the patient for clues and keys to the best possible treatment plan. Migraines are very individual in the ways they strike and migraine triggers differ from patient to patient. You want to have a doctor who really listens to what you have to say.

Consider Side Effects

The choice of which preventive medication your doctor will prescribe for you will be based on the known side effects of a particular drug and any medical condition you may have aside from migraines. The first drug a doctor might try is Inderal (propranolol) but only if you don't have heart disease, COPD, or asthma. Inderal can exacerbate asthma, and makes patients tired but tends to be well-tolerated. The price isn't as high as some preventive medication with a twice daily regimen costing about $40.00 a month.

Another effective drug that is in common use for migraines is Elavil (amitriptyline). Elavil is popular because it is the cheapest of all the preventive medications costing about $5.00 per month. The drawback is the high percentage of side effects; dry mouth, sedation, constipation, and weight gain are typical.

A third choice for preventive medication is Topamax (topiramate). This medication has grown in popularity due to an association with weight loss. Most obese migraine patients can expect to lose about 10% of their body weight in the course of one year on Topamax.

Preventive medication is given in the lowest effective dose, but your doctor will be watching your response—he may need to make gradual increases in the dose until it does the trick. This gradual increase is the best way to minimize any possible side effects. These medications are taken every day for months or years. If it is decided that you should discontinue treatment, the dose must be reduced in a gradual manner. An abrupt stoppage could lead to severe migraine headaches.

Sometimes more than one drug is needed to give good results. Other therapies may also be needed, for instance, behavioral therapy may be an effective as an addendum to your migraine treatment plan.