Prophylactic, preventive medications for the treatment of migraine headaches: an introduction
People who have regular, severe migraine attacks may benefit from taking medicines on a consistent basis to prevent attacks or reduce the frequency. These medications, called prophylactic or preventive medications, are often taken daily to avoid migraine attacks.
Some patients, who have a known migraine trigger, may take the prevention medication just when exposed to that trigger – which may be ascending to a higher altitude or engaging in sexual activity. Others may need to take preventive medication on a regular, but not daily basis, such as those patients who suffer from migraines related to their menstrual cycle.
Migraine prevention medications are also approved for other uses. Migraine sufferers usually use a lower dose of prevention medication than is prescribed for treating other ailments.
The goal of prophylactic migraine treatments
Migraine attacks can cause severe pain, uncomfortable symptoms, contribute to disability and lead to a reduced quality of life. Patients whose migraines are common, may choose to take a medicine every day to keep migraines away. These migraine prevention treatments sometimes stop the attacks, make them less severe or less frequent. Half of migraine sufferers who take prophylactic treatment for migraines see their number of migraine attacks cut in half. It may take a while – sometimes two months – before prevention drugs begin to work. Sometimes after six months or a year, doctors will encourage migraine patients to reduce or stop taking prevention medications to see if any benefits continue. If the attacks return, prevention therapy can begin again.
Who are good candidates for preventive migraine medication?
According to the U.S. Headache Consortium of the American Academy of Neurology, the following guidelines can be used to determine which patients would best benefit from using preventive migraine treatment:
- Patients whose attacks cause severe migraine symptoms, debilitation and greatly interferes with the normal routine
- Those who have frequent attacks, generally more than twice monthly
- People who don’t respond well to abortive medications for immediate relief or who have other health issues that prevent them from using migraine pain killers at the time of the migraine attack
- Migraine sufferers who have certain types of migraines that respond well to preventive therapy
For women who have menstrual migraines, 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.