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Medications for Headache and Migraine Prevention

Effective preventive regimens can be found for 95-98% of patients

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Updated: April 15, 2006

Preventive Medications

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

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  6. Medications for Headache and Migraine Prevention from About Headaches and Migraine

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