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Migraine preventive medication
Preventive migraine medication aims to reduce attack frequency, severity, duration, or disability when attacks are frequent or hard to control.
Migraine preventive medication is taken regularly to reduce the burden of attacks. It is different from acute medication, which treats an attack already happening.
When is prevention considered?
Prevention may be discussed when attacks are frequent, very disabling, prolonged, hard to treat, or causing repeated missed work, school, caregiving, or life activities. American Migraine Foundation notes prevention is often considered for more than four migraine attacks a month or very disabling attacks.
Prevention can also be considered when acute medication cannot be used safely, when attacks have long recovery time, or when medication-overuse headache risk is becoming part of the pattern.
Types of preventive treatment
Options can include beta blockers, certain antidepressants, anti-seizure medicines, CGRP-targeting therapies, onabotulinumtoxinA for chronic migraine, behavioral approaches, and lifestyle routines. Choice depends on your history and clinician guidance.
How to judge whether it works
Preventive treatment is usually judged over weeks to months, not one attack. Track migraine days, headache days, medication days, missed activities, side effects, and attack severity before and after starting treatment.
Questions to ask
- What outcome are we trying to improve?
- How long should I try this before judging it?
- What side effects should I watch for?
- What if I am pregnant, trying to become pregnant, or breastfeeding?
- Does this interact with my other medicines?
- What should I still use during breakthrough attacks?
Do not stop abruptly without advice
Some preventive medicines need careful tapering. Ask your clinician what to do if side effects occur or if you want to stop.
Sources
- American Migraine Foundation: Migraine prevention 101
- American Migraine Foundation: Understanding migraine medications
- Mayo Clinic: Migraine diagnosis and treatment
Migraine Manager is a personal health journal, not a medical device. It does not diagnose or treat any condition. Always follow your clinician's advice for diagnosis, medication, and treatment decisions.
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When is prevention considered?
Prevention may be discussed when attacks are frequent, very disabling, prolonged, hard to treat, or causing repeated missed work, school, caregiving, or life activities. American Migraine Foundation notes prevention is often considered for more than four migraine attacks a month or very disabling attacks. Prevention can also be considered when acute medication cannot be used safely, when attacks have long recovery time, or when medication-overuse headache risk is becoming part of the pattern.