Are You a Candidate for Preventive Migraine Treatment?  

Managing migraine can make you feel like you need an arsenal of medications at your side. Rescue medications help stop attacks that have already started. However, preventive migraine treatment can help reduce the number and severity of attacks. As part of their personalized treatment plans, options may include daily pills, devices, or monthly or quarterly injections. Preventive therapies are used to try to reduce how often and how severe migraine attacks are. Many different preventive therapies are available and choosing which the best one for you is depends on many factors, including co-existing medical conditions.

The Goals of Migraine Prevention

The goal of preventive migraine treatment is to reduce the frequency and overall impact associated with migraine attacks. Migraine preventives may also improve acute treatment responsiveness. This helps prevent emergency department and acute care visits, and can help reduce acute medication intake. Preventive treatment strategies might not eliminate migraine attacks completely. But they can significantly improve a patient’s quality of life.

Who is a Candidate for Preventive Migraine Treatments? 

Preventive therapies are prescribed for any of the following reasons:

  • Disabling attacks despite appropriate acute treatment
  • Frequent attacks, such as four or more migraine days per month, four or more moderate to severe headache days per month, or migraine that interferes with work or daily activities per the new AHS/AAN guidelines.
  • Insufficient or no response to acute treatment
  • Poor tolerance or contraindications for specific acute treatments
  • A history of long-term, frequent or excessive use of pain medications or acute medications that make headaches worse
  • Patient preference

Preventive treatment strategies can include medications, supplements, and sometimes even devices. Discuss treatment and management options with your physician to make this decision.

In 2026, the American Headache Society (AHS) and American Academy of Neurology (AAN) published an updated joint practice guideline on pharmacologic treatment for migraine prevention in adults. The guideline, which updates the previous AAN/AHS guideline from 2012, incorporates evidence on both established and newer preventive treatments, including migraine-specific therapies. It provides recommendations for people with both episodic and chronic migraine and emphasizes considering factors such as migraine frequency, impact on daily activities, treatment effectiveness, potential side effects, and patient preferences when choosing a preventive treatment.

The updated guideline recommends considering preventive treatment for people who experience four or more migraine days per month, four or more moderate to severe headache days per month, or migraine that interferes with work or daily activities. Treatment decisions should be individualized and made through shared decision-making between patients and their healthcare professionals. More information on the new guidelines can be found here.

Relentless Treatment for Relentless Migraine

Prevention is not a cure, but it can help reduce the frequency and/or severity of migraine attacks and improve quality of life. The amount that an individual preventive can reduce migraine attacks in a given person varies, but a target of reducing attacks by at least 50% without any bothersome side effects is the goal for most patients. Those who are good candidates for preventative strategies could see the burden of their migraine greatly reduced.

Because there is not a “one size fits all” treatment strategy, preventive therapies must be individualized. Patients with migraine exploring the best migraine prevention treatments need guidance and experience that only healthcare professionals can provide. For help finding a headache specialist who can help you determine if you should explore preventive strategies, check out our Find a Doctor tool.