More than just a bad headache, a migraine is debilitating. It’s one of the top five reasons people go to the emergency room. An estimated 38% of people living with migraines will benefit from preventive (prophylactic) medication, but less than 13% take medication. For people taking preventive medicine, the first attempt may not be effective enough. Don’t give up, especially if you’ve been diagnosed with chronic migraine, in which you experience headaches at least 15 days a month. Finding the right preventive treatment can be a process, but it’s well worth it to get closer to the goal of migraine-free.
Many studies have shown that migraines significantly affect quality of life. Consider how migraine attacks affect your ability to see these daily activities through:
- Family time
- Social activities, entertainment and relaxation
Absences and cancellations tend to be accompanied by migraines, as well as interpersonal conflicts and miscommunication. You don’t have to accept a life where you miss important moments or fail to perform as you would like in many of your roles.
Medications that prevent migraines may reduce your need for acute migraine treatment, which may not always relieve your migraines as quickly or as effectively as you would like. Although many people who take medication to prevent migraines may still experience some migraine attacks, they are much less common and can be less severe. In addition, some people who regularly take medication for acute migraine headaches may experience overuse headaches. That’s right – by taking your migraine medicine too often, you can trigger more migraine attacks.
Fortunately, medications that prevent migraines can reduce these attacks and stop the cycle. Preventive therapies that can help include:
- Anticonvulsants such as topiramate (Topamax) and valproic acid (Depakote)
- Beta-blockers such as metoprolol (Lopressor), nadolol (Corgard), and propranolol (Inderal)
- Botulinum toxins like Botox
- Calcium channel blockers such as diltiazem (Cardizem) and verapamil (Calan)
- Antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl), and venlafaxine (Effexor XR)
- CGRP inhibitors such as atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality)
Migraines are more common in women than men, and the fluctuating hormones of the menstrual cycle are one reason. The first-line medication for menstrual migraines is frovatriptan (Frova) and the second-line drug is naratriptan (Amerge) or zolmitriptan (Zomig).
Some menstrual migraines respond best to hormonal treatment. How do you know if your migraine is menstrual? They tend to happen on a regular schedule, starting two days before your period until three days after. Endocrine treatments may include:
- Combined hormonal contraceptives in the form of pills, patches, or vaginal rings
- Progesterone-only birth control pills, implants, or injections
- Estrogen patch or gel
Have you experienced any of the signs that it’s time to try a migraine-preventing medication? Make an appointment with your doctor to begin discovering the best first step to long-term pain relief.