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When discussing preventive medications, it's not
at all unusual to hear someone with frequent Migraines or headaches say, "I've
tried everything!" In the reality of today's headache and Migraine medicine,
that's just not possible. As you can see from the list below, there are over 100
medications and dietary supplements, as well as at least one medical device, being used successfully for
headache and Migraine prevention. There are also virtually endless combinations
of them. Many people find that it's not a single medication or supplement that
ends up being successful for them, but a combination of preventives. 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, aka Catapres
- Guanfacine, aka Tenex
ACE Inhibitors:
- Benazepril, aka Lotensin
- Captopril, aka Capoten
- Enalapril, aka Vasotec
- Fosinopril, aka Monopril
- Lisinopril, aka Zestril, Prinivil
- Moexipril, aka Univasc
- Perindopril, aka Aceon
- Quinapril, aka Accupril
- Ramipril, aka Altace
- Trandolapril, aka Mavik
Alzheimer's/Dementia Medicaton:
Angiotensin II Inhibitors:
- Candesartan, aka Atacand
- Eprosartan, aka Teveten
- Irbesartan, aka Avapro
- Losartan, aka Cozaar
- Olmesartan, aka Benicar
- Telmisartan, aka Midcardis
- Valsartan, aka Diovan
Beta Blockers:
- Acebutolol, aka Secral
- Atenolol, aka Tenormin
- Betaxolol, aka Kerlone
- Bisoprolol, aka Zebeta, Emconcor
- Cartelol, aka Cartrol
- Labetalol, aka Normodyne, Trandate
- Metoprolol, aka Lopressor
- Nadolol, aka Corgard
- Penbutololm aka Levatol
- Pindolol, aka Visken, Syn-Pindolol
- Propranolol, aka Inderal
- Timolol, aka Blocadren
Calcium Channel Blockers:
- Amlodipine, aka Norvasc
- Bepridil, aka Vascor
- Diltiazem, aka Cardizem, Tiazac
- Felodipine, aka Plendil
- Flunarizine, aka Sibelium (Canada)
- Isradipine, aka DynaCirc
- Nicardipine, aka Cardene
- Nifedipine, aka Adalat, Procardia
- Nimodipine, aka Nimotop
- Nisoldipine, aka Sular
- Verapamil, aka Calan, Verelan, Isoptin
ANTIHISTAMINES:
- Cyproheptadine, aka Periactin
- Pizotifen, aka Sandomigran (UK)
ANTIDEPRESSANTS
Tricyclic antidepressants (TCAs):
- Amitriptyline, aka Elavil (discontinued), Endep
- Amoxapine, aka Asendin
- Clomipramine, aka, Anafranil
- Desipramine, aka Norpramin
- Doxepin, aka Sinequan
- Imipramine, aka Norfranil, Tofranil
- Nortriptyline, aka Pamelor, Aventyl
- Protriptyline, aka Vivactil
- Trimipramine, aka Surmontil
MAOI Antidepressants:
- Isocarboxazid, aka Marplan
- Phenelzine, aka Nardil
- Tranylcypromine, aka Parnate
Selective serotonin reuptake inhibitors (SSRIs):
- Citalopram, aka Celexa
- Escitalopram oxalate, aka Lexapro
- Fluoxetine, aka Prozac
- Fluvoxamine, aka Luvox
- Paroxetine, aka Paxil
- Sertraline, aka Zoloft
Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs):
- Duloxetine hydrochloride, aka Cymbalta
- Venlafaxine, aka Effexor, Effexor XR
Other Antidepressants:
- Bupropion, aka Wellbutrin, Zyban
- Mirtazepine, aka Remeron
- Trazodone, aka Desyrel
Attention Deficit Hyperactivity
Disorder Meds:
- Dextroamphetamine, aka Adderall
- Atomoxetine HCl, aka Strattera
- Methylphenidate HCl, aka Concerta, Ritalin
- Pemoline, aka Cylert
ARTHRITIS MEDS
Cox-2 Enzyme Inhibitors:
MUSCLE RELAXANTS:
- Carisoprodol, aka Soma
- Cyclobenzaprine, aka Flexeril
- Lioresal, aka Baclofen
- Metaxalone, aka Skelaxin
- Tizanidine, aka Zanaflex
NEURONAL STABILIZING AGENTS (antiseizure meds)
Many people call this class of medications "antiseizure medications."
Actually, these meds are neuronal stabilizing agents. They work to stabilize the
neuronal activity in the brain. Considering that Migraineurs have overactive
neurons in the brain that, when a trigger is encountered, start firing in a wave
and start a chain reaction that produces the symptoms of a Migraine attack, it
makes sense to use them for Migraine prevention. These meds are only antiseizure
meds when they're being used to prevent seizure activity.
- Carbamazepine, aka Tegretol
- Clonazepam, Klonopin
- Clorazepate, aka Tranxene
- Divalproex, aka Depakote
- Gabapentin, aka Neurontin
- Levetiracetam, Keppra
- Lamotrigine, aka Lamictal
- Oxcarbazepine, Trileptal
- Tiagabine, aka Gabitril
- Topiramate, aka Topamax
- Valproate Sodium, aka Depacon
- Zonisamide, aka Zonegran
- Pregabalin, aka Lyrica
ERGOT ALKALOID:
- Methylergonovine, aka Methergine (the only ergot used as a preventive)
LEUKOTRIENE BLOCKERS:
- Montelukast, aka Singulair
- Zafirlukast, aka Accolate
- Zyleuton, aka Zyflo
OTHER:
DIETARY SUPPLEMENTS:
- Coenzyme Q10
- Feverfew
- Butterbur, aka Petadolex
- Magnesium
- Vitamin B2
- 5-HTP (Check carefully with doctor because of interactions with meds
including triptans and SSRIs)
- Lecithin
- Melatonin
DEVICES:
- The
NTI Tension Suppression
System, invented by Dr. Jim Boyd, has proven quite effective for some
people who have problems with clenching or grinding their teeth in their
sleep.
This list will be updated as more medications are successfully used for
headache and Migraine prevention. If you're having problems finding an effective
preventive regimen, sharing this list with your doctor may be helpful to you.
References:
Ramadan, Nahib M., MD; Silberstein, Stephen D., Md, FACP; Frietag, Frederick
G., DO; Gilbert, Thomas T., MD, MPH; Frishberg, Benjamin M., MD. "Evidence-Based
Guidelines for Migraine Headache in the Primary Care Setting: Pharmacological
Management for Prevention of Migraine." American Academy of Neurology Practice
Guidelines. September, 2000.
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