Few patients use preventive treatments

Preventive therapy isn't always a prescription. Some patients do quite well using supplements such as Riboflavin, Magnesium, Feverfew, Butterbur, and more. Still others respond best to Botox, SPG blocks, occipital nerve blocks, neurostim implants, Cefaly, Spring TMS, or even surgery. There are so many options to try that it would take over 25 years to give each one a fair 90 day trial. Plus, promising new treatment options are currently in clinical trials.

Few patients use preventives

According to the American Migraine Prevalence and Prevention (AMPP) study1, over 38% of all migraineurs are candidates for preventive therapy, yet only 12% of those candidates are actually receiving preventive therapy3. That means that 38 out of every 100 visitors to Migraine.com could benefit from preventives but only 4 of them are actually receiving preventive treatment.

Reasons patients do not use preventives

  • Concerns about side effects
  • Frustration over multiple failed treatments
  • Doctor has said there are no more options
  • Unaware that preventives are available
  • Unaware that their attacks are severe enough to warrant preventive therapy
  • Unaware of all the preventive options available.

Can you think of other reasons someone might not use preventive therapies?

When to seek preventive treatment

There are no clear-cut rules as to when preventive treatment should be started. However, the general guidelines take into account both frequency and severity of impairment.


According to the AMPP study, impairment severity is classified as 1) no impairment, 2) some impairment (can function with reduced productivity), and 3) severe impairment (cannot function or require bed rest). The study also found that 91% of patients say they cannot function at all during an attack. 3


Experts recommend that patients start preventive therapy long before they become chronic. In fact, high frequency of attacks is one of the risk factors for the development of Chronic Migraine2. Preventive therapies aim to reduce the frequency of attacks, thereby reducing your risk for developing Chronic Migraine.

The cutoff for preventive therapy starts with as few as 2 attacks per month, particularly if those attacks are severe enough to prevent you from functioning. Even if your attacks are relatively mild, you may be a candidate for preventive therapy with only 4-6 attacks per month. That's a pretty low threshold. According to headache experts, the only migraineurs who should not be using preventive medicine are those with fewer than 2 attacks per month3.

Ask your doctor if preventive therapy is right for you.

For decades I was content to treat each attack as a separate condition. In my mind, migraine was an irritating nuisance that got in my way. I did not understand that migraine is a serious neurological disorder that progressively worsens if left untreated. If I would have understood the risk when I first sought treatment, I would have been more insistent on starting preventive therapy.

If you are experiencing frequent migraine attacks and still just treating each attack as it comes, don't you think you owe it to yourself and your loved ones to ask your doctor about preventive treatment options?

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