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Migraine and Headache Preventive Medications - Too Many Options To Give Up!

by Teri Robert, Lead Expert

For those of us with frequent headaches or Migraine attacks, preventive medications 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 discovery is often made when patients taking the medications for their original purpose notice a reduction in the frequency of their headaches or Migraines. 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 headache and Migraine specialists can tell us that effective preventive regimens can now be found for 95-98% of patients. It can take up to three months to know if a medication is effective for you, but with time, patience, and a good doctor, there is hope!

The vast majority of medications prescribed as preventives are prescribed off-label. That means that although they have been approved by the FDA, they have not been approved specifically for Migraine and headache prevention. Only five medications have been approved specifically for this purpose:

  • propranolol, brand Inderal
  • timolol, brand Blocadren
  • divalproex, brand Depakote
  • topiramate, brand Topamax
  • onabotulinum Toxin Type A, brand Botox (approved for chronic Migraine only, Migraine occurring 15 or more days a month)

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, brand Catapres
  • guanfacine, brand Tenex

ACE Inhibitors:

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