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Migraine Prevention Medications

Prophylactic, preventive medications for the treatment of migraine headaches

People who have regular, severe migraine attacks may benefit from taking medicines on a consistent basis to prevent attacks or reduce the frequency of attacks. These medications, called prophylactic or preventive medications, are often taken daily to avoid migraine attacks. Preventive medications are different from acute medications (also called abortive medications), which are used when a migraine attack occurs to stop the symptoms and provide immediate relief.

Medications that are used for migraine prevention may also be approved for other uses. Migraine sufferers usually use a lower dose of prevention medication than is prescribed for treating other ailments. A preventive migraine drug is considered successful if it reduces migraine attack frequency by at least 50% within 3 months.1

The goal of prophylactic migraine treatments

Migraine attacks can cause severe or debilitating pain and can contribute to disability and lead to a reduced quality of life. People who suffer from chronic migraine may choose to take a medicine every day to keep migraine attacks away. The goals of migraine prevention treatments are:

  • To reduce the frequency, severity, and/or duration of migraine attacks
  • To improve the responsiveness of acute attacks
  • To reduce disability from migraine attacks2

Who are good candidates for preventive migraine medication?

The American Migraine Prevalence and Prevention Study created guidelines to determine which patients would best benefit from using preventive migraine treatment.

Prevention treatment should be started in those who have:

  • Six or more migraine attacks per month
  • Four or more migraine days with at least some impairment
  • Three or more migraine days with severe impairment or requiring bed rest3

In addition, prevention treatment should be considered in those who have:

  • Four to five migraine days per month with normal functioning
  • Two to three migraine days a month with some impairment
  • Two migraine days a month with severe impairment3

For women who have menstrual migraine, that occur before or at the very beginning of almost every menstrual cycle may benefit from short-term prophylactic, preventive medication. In this case, women may be prescribed medicine that is taken only for one or two days before the migraine symptoms typically appear and then during the period.4

Keeping a migraine journal will help the doctor determine the severity of migraine attacks and give the migraine specialist a better understanding of which medications may work best.

Types of migraine prevention treatments

The selection of preventive migraine medication is based on the individual, the type of migraine they have, other health conditions they may have, their preference in treatment, possible side effects, and their responsiveness to the medication. Medications work differently in different people, and several different preventive medications may need to be tried to find the right one for an individual. In addition, it can take awhile before the medication begins to work, and doctors recommend trying the medication for at least two months before switching to another option.3

Vitamins, minerals, and herbs may also be used in the prevention of migraine.3 People with migraine should make sure to tell their doctor about all medications and supplements they are taking, as some may interact badly with each other or cause serious side effects when taken together.


Written by: Emily Downward | Last review date: August 2019
  1. Silberstein SD. Preventive Migraine Treatment. Continuum : Lifelong Learning in Neurology. 2015;21(4 Headache):973-989. doi:10.1212/CON.0000000000000199.
  2. Chawla J. Migraine headache treatment & management. Medscape. Available at Accessed 5/1/18.
  3. Estemalik E, Tepper S. Preventive treatment in migraine and the new US guidelines. Neuropsychiatric Disease and Treatment. 2013;9:709-720. doi:10.2147/NDT.S33769.
  4. Menstrual migraine. The American Headache Society. Available at Accessed 5/1/18.
  5. Migraine: the CGRP story. Pharmaceutical Journal. Available at Accessed 5/10/18.
  6. FDA Approves Aimovig (erenumab-aooe), a Novel Treatment Developed Specifically for Migraine Prevention. Amgen press release. Available at Accessed 5/17/18.