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Information from Your Family Doctor
Medicines to Prevent Migraine Headaches
Am Fam Physician. 2006 Jan 1;73(1):79-80.
See related article on migraine prophylaxis.
What are migraines?
A migraine is a type of headache that is very painful. Migraines aren’t the same for everyone. Often, people with migraines have blurred vision or a blind spot before the headache starts. If you have a migraine, you may feel a throbbing pain on one side of your head. Bright lights or loud noises may make it worse. Some people have an upset stomach when they have a migraine, and some people throw up.
What causes migraines?
Different things can cause migraines. Bright or flickering lights, some foods or smells, and some medicines may cause them. You may get a migraine when you are hungry or stressed, or if you get more or less sleep than usual. Some women have migraines that are caused by their monthly periods.
How are migraines treated?
There is no cure for migraines, but there are medicines that can help. It is important to find the medicine that works best for you. Some medicines help stop the pain after the migraine starts. These are called “pain control” medicines. Pain control medicines should be taken as soon as you think you’re getting a migraine.
How can I prevent migraines?
Some people find it helpful to keep a headache diary. This can help you to see what things cause, or “trigger,” your migraines, so you know what to avoid. Ask your doctor if any medicines you are taking might trigger migraines. Find out if certain foods trigger your migraines. Try to get enough sleep each night (usually about eight hours) and eat at regular times. Lowering the amount of stress in your life also may help.
If your migraines happen often and you cannot find what triggers them, your doctor may suggest that you try a “preventive” medicine.
What is preventive medicine?
Preventive medicines can prevent headaches from happening. Some people who have a lot of migraines take preventive medicine every day. Even if you take preventive medicine, you still may need to take pain control medicine when you feel a headache start.
You may need to take preventive medicine for two to six months before it helps. Be patient and give the medicine time to work. If one medicine doesn’t work, your doctor might add a new one or have you try a different one. If none of the medicines work, there are other treatments your doctor might try.
Ask your doctor how to take the medicine and what side effects to watch out for. See your doctor often while you are finding which medicine works best for you. Be sure to keep track of which medicines you’ve tried and how well they worked.
Are there any over-the-counter medicines I can try?
Some pills that help prevent migraines are sold without a prescription. These include naproxen (one brand name: Aleve), magnesium, and vitamin B2 (riboflavin). You should always talk to your doctor about any medicines before you try them. Your doctor will make sure they are safe to take with other medicines or with any medical conditions you may have.
Will I need to take preventive medicine for the rest of my life?
Once you find a medicine that works for you, you should keep taking it for at least six months. After six to twelve months, your doctor may take you off the medicine slowly. Many people feel better than before, even after they stop taking medicine. If your migraines get worse, you may need to take preventive medicine again.
Where can I get more information?
National Headache Foundation
Web site: http://www.headaches.org
American Council for Headache Education
Web site: http://www.achenet.org
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2006 by the American Academy of Family Physicians.
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