Using over-the-counter and prescription medications to stop the excruciating pain associated with migraines is a common approach. But a new approach is slowly being adopted by doctors specializing in the treatment of headaches and migraines – using medications to prevent the onset of a migraine attack on the first place.
Most, if not all, of these drugs are formulated in the treatment of other medical conditions but can be effective in the prevention of migraine attacks by addressing the causes of the headaches. In other words, the drugs act in an indirect manner on the migraine.
For example, a few of these drugs should be taken on a daily basis in order to regulate blood vessel activity or to suppress certain the release of brain chemicals, among other actions. Doctors hope that in addressing the root cause of the chain of events leading to a migraine attack, its onset can be largely prevented.
The most common drugs used for this purpose are:
Studies have shown that many individuals with chronic migraines have a favorable response to these medications in terms of prevention of attacks. But it must be emphasized that not everybody can tolerate these medications so alternative treatments will be necessary.
Botox, the muscle-paralyzing drug used in cosmetic procedures, can be a saving grace for many individuals. Studies have shown that it can be effective for people with frequent migraines especially when injected every 3-4 months.
The injections can be expensive. Ask your insurance carrier whether your healthcare policy covers the treatment or not but if Botox prevents chronic migraines for prolonged periods, then the expense is well worth it.
Pick the Side Effects
And then there’s the downside of these medications – the side effects. Doctors will usually discuss the possible side effects of each medication with their patients and then let them choose which set of side effects thy can live with, so to speak.
For example, Topamax can cause tingling, numbness and slowed cognitive function as well as weight loss – a good side effect for many people. In contrast, Depakote causes weight gain, a side effect also known in a few tricyclic antidepressants and calcium channel blockers.
Doctors are also looking into the so-called drug timing wherein the drugs are taken according to the window of vulnerability, a crucial period for sufferers of migraines. The drugs should be taken within this window of vulnerability for best results including the minimization of side effects.
The bottom line: Doctor-patient discussions about the pros and cons of medications used in the prevention of migraine attacks must be an on-going process. As with most anti-migraine medications, trial and error in the type, dosage and duration of intake will be necessary until the right combo can be found.