For those of us with frequent headaches or Migraine attacks, preventive medications, supplements, and devices are often a good option. Amazingly, the medications used for this purpose were all originally developed for other conditions then found to be effective as headache and / or Migraine preventives. The list is ever-evolving. Even as I publish this list of medications that I've compiled, there are bound to be some that I've not read or heard about yet.
When you consider the list below and the nearly endless possible combinations of these medications, it's easier to see how specialists can tell us that effective preventive regimens can now be found for 95-98% of patients.
The following medications are being used successfully by some headache and Migraine patients as preventive medications. They're listed first by their generic names, followed by some of their brand names.
ANTIHYPERTENSIVES (blood pressure meds)
Alpha-2 agonists:
- Clonidine, aka Catapres
- Guanfacine, aka Tenex
ACE Inhibitors:
- Benazepril, aka Lotensin
- Captopril, aka Capoten
- Enalapril, aka Vasotec
- Fosinopril, aka Monopril
- Lisinopril, aka Zestril, Prinivil
- Moexipril, aka Univasc
- Perindopril, aka Aceon
- Quinapril, aka Accupril
- Ramipril, aka Altace
- Trandolapril, aka Mavik
Angiotensin II Inhibitors:
- Candesartan, aka Atacand
- Eprosartan, aka Teveten
- Irbesartan, aka Avapro
- Losartan, aka Cozaar
- Olmesartan, aka Benicar
- Telmisartan, aka Midcardis
- Valsartan, aka Diovan
Beta Blockers:
- Acebutolol, aka Secral
- Atenolol, aka Tenormin
- Betaxolol, aka Kerlone
- Bisoprolol, aka Zebeta, Emconcor
- Cartelol, aka Cartrol
- Labetalol, aka Normodyne, Trandate
- Metoprolol, aka Lopressor
- Nadolol, aka Corgard
- Penbutololm aka Levatol
- Pindolol, aka Visken, Syn-Pindolol
- Propranolol, aka Inderal
- Timolol, aka Blocadren
Calcium Channel Blockers:
- Amlodipine, aka Norvasc
- Bepridil, aka Vascor
- Diltiazem, aka Cardizem, Tiazac
- Felodipine, aka Plendil
- Flunarizine, aka Sibelium (Canada)
- Isradipine, aka DynaCirc
- Nicardipine, aka Cardene
- Nifedipine, aka Adalat, Procardia
- Nimodipine, aka Nimotop
- Nisoldipine, aka Sular
- Verapamil, aka Calan, Verelan, Isoptin
Other Antihypertensives:
- Guanfacine, aka Tenex
- Mirtazapine, aka Remeron
ANTIHISTAMINES:
- Cyproheptadine, aka Periactin
- Pizotifen, aka Sandomigran (UK)
ANTIDEPRESSANTS
Tricyclic antidepressants (TCAs):
- Amitriptyline, aka Elavil (discontinued), Endep
- Amoxapine, aka Asendin
- Clomipramine, aka, Anafranil
- Desipramine, aka Norpramin
- Doxepin, aka Sinequan
- Imipramine, aka Norfranil, Tofranil
- Nortriptyline, aka Pamelor, Aventyl
- Protriptyline, aka Vivactil
- Trimipramine, aka Surmontil
MAOI Antidepressants:
- Isocarboxazid, aka Marplan
- Phenelzine, aka Nardil
- Tranylcypromine, aka Parnate
Selective serotonin reuptake inhibitors (SSRIs):
- Citalopram, aka Celexa
- Escitalopram oxalate, aka Lexapro
- Fluoxetine, aka Prozac
- Fluvoxamine, aka Luvox
- Paroxetine, aka Paxil
- Protriptyline, aka Vivactil
- Sertraline, aka Zoloft
Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs):
- Duloxetine hydrochloride, aka Cymbalta
Other Antidepressants:
- Bupropion, aka Wellbutrin, Zyban
- Mirtazepine, aka Remeron
- Trazodone, aka Desyrel
- Venlafaxine, aka Effexor, Effexor XR
Attention Deficit Hyperactivity Disorder Meds
Selective Norepinephrine Reuptake Inhibitor:
- Atomoxetine HCl, aka Strattera
ARTHRITIS MEDS
Cox-2 Enzyme Inhibitors:
- Celecoxib, aka Celebrex
NEURONAL STABILIZING AGENTS (antiseizure meds)
- Carbamazepine, aka Tegretol
- Clonazepam, Klonopin
- Clorazepate, aka Tranxene
- Divalproex, aka Depakote
- Gabapentin, aka Neurontin
- Levetiracetam, Keppra
- Lamotrigine, aka Lamictal
- Oxcarbazepine, Trileptal
- Pregabalin, aka Lyrica
- Tiagabine, aka Gabitril
- Topiramate, aka Topamax
- Valproate Sodium, aka Depacon
- Zonisamide, aka Zonegran
Ergot Alkaloid:
- Methylergonovine, aka Methergine (the only ergot used as a preventive)
Leukotriene Blockers:
- Montelukast, aka Singulair
- Zafirlukast, aka Accolate
- Zyleuton, aka Zyflo
Other:
- Baclofen, aka Lioresal
- Botulinum Toxin Type A, aka Botox
Medication for Alzheimer's Type Dementia:
- Memantine, aka Namenda
Dietary Supplements:
- Coenzyme Q10
- Feverfew
- Butterbur, aka Petadolex
- Magnesium
- Vitamin B2
- 5-HTP (Check carefully with doctor because of interactions with meds including triptans)
- Lecithin
- Melatonin
- Combination supplements such as MigraHealth and Migra-Lieve.
Medical Devices:
- The NTI Tension Suppression System (Dental)
This list will be updated as more preventives are successfully recognized for headache and Migraine. If you're having problems finding an effective preventive regimen, sharing this list with your doctor may be helpful.
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References:
Ramadan, Nahib M., MD; Silberstein, Stephen D., Md, FACP; Frietag, Frederick
G., DO; Gilbert, Thomas T., MD, MPH; Frishberg, Benjamin M., MD. "Evidence-Based
Guidelines for Migraine Headache in the Primary Care Setting: Pharmacological
Management for Prevention of Migraine." American Academy of Neurology Practice
Guidelines. September, 2000.
Updated April 14, 2006
