Preventive Migraine Treatment: An Introduction

Are you a good candidate for preventive migraine medications?  

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, patients who use these treatments typically take their medication on a daily basis, although newer injectable agents can be taken once every 1-3 months. Preventive therapies are used to try to prevent the chances of an attack. Many different preventive medications are available, and choosing which ones depends on many factors, including co-existing 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 are also intended to improve acute treatment responsiveness. This helps prevent emergency department and acute care visits and reducing excessive overuse of acute medications. Preventive treatment strategies might not eliminate migraine 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 people who experience: 

  • Disabling attacks despite appropriate acute treatment
  • Frequent attacks, such as one per week or more
  • Insufficient or no response to acute drug 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

Those who experience frequent attacks will need more aggressive prevention strategies. This can include medication and supplements. Discuss treatment and management options with your physician to make this decision.

In 2012, guidelines were published by the American Headache Society outlining recommendations for migraine prevention medications based on evidence from published studies and clinical experience. Choosing a preventive medication involves balancing how well it works with any potential side effects.

Relentless Treatment for Relentless Migraine

Prevention is not a cure. But it can help reduce the frequency, severity, and/or intensity of the headaches. The amount that an individual preventive can reduce migraine varies. But most doctors hope for an improvement in migraine frequency of around 50%. Like with any medication, patients and doctors should discuss side effects. But preventive treatment has the potential to improve a patient’s quality of life. Those who are good candidates for these strategies could see the effect 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 medication 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.