What Migraine Prevention Medications Would You Choose From This List?

Find the specific migraine prevention medications you need with the details and common side effects listed below. Educate yourself before and after the doctor’s appointments with this information.

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I sure wish I had the internet as a resource when I was trialing medications.

WOW - does that make me sound old! Well, I am old ish, but I also wish I had better access to resources.

Back then I just relied on what my one doctor said.

I urge you to read and make sure you know what you are taking before you take it.

Your pharmacist is also a wealth of knowledge, so don't be afraid to ask questions.

The aim of migraine prevention medications is to lessen the frequency, intensity and duration of the migraine attacks. Much lower doses are required than those used to treat the common or co-existing disorder.

Talk to your doctor about what you want from your medications, so you are both clear. Doctors aim for noticeable reduction (50%), you may want more.

Plus, not all doctors know how to treat migraines so please search for one that does specialize in, and have success with, treating migraine headaches.

FDA Approved First Line Treatment

These four migraine prevention medications are FDA approved and are most likely what your doctor will prescribe first:

  • Divalproex sodium (Depakote®)
  • Propranolol (Inderal®)
  • Timolol (Blocadren®)
  • Topiramate (Topamax®)

Taking the right dose for a good trial period is essential to determine what will be most effective at reducing your attacks.

It might take 3 months or more to see results.

You may need to reduce the dose if you are experiencing side effects. This is called “titration” and needs to be discussed with your doctor.

For getting more help from your Doctors visit, feel free to use our Doctors treatment strategy form on migraine prescription medication to organize your pain medications.

Also, please note that you may need both migraine prevention medications and an acute triptan medication to deal with your migraines effectively.

The List of Migraine Prevention Medications

Here is the list of migraine prevention medications – Beta blockers, Calcium channel blockers and the Antidepressants are all considered first line treatment agents.

Migraine Prevention Medications Disclaimer

Anti-Seizure Medications

Migraine Prevention Medications
  • Gabapentin (Neurontin®, Gralise and Horizant)
  • Sodium Valproate (Epilim®)
  • Topiramate (Topamax®)
  • Valproic Acid (Depakote®, Epival, Epival VR, Valance, Diprate OD)

Used for: epilepsy and other seizure disorders, and reduce frequency of migraines at much lower doses that required to treat common disorder.

Common side effects: hair loss, weight gain (except weight loss with Topiramate), cramps, dizziness, nausea and vomiting, reflux, tremor, heartburn, skin rash or strange sensations like itching or prickling (paresthesias).

Tricyclic Antidepressants

  • Amitriptyline (Elavil®, Endep®)
  • Nortriptyline (Pamelor®, Aventyl®)
  • Protriptyline (Vivactil®)

Used for: depression, insomnia or sleep disturbances, anxiety and reducing migraines by affecting the level of the brain chemical serotonin.

Common side effects: dizziness, weight gain, fatigue, dry mouth, arrhythmia's, blurred vision, urinary hesitancy and reduced libido (sex drive).

Selective Serotonin Reuptake Inhibitors (SSRI’s)

  • Sertraline (Zoloft®, Lustral®)
  • Fluoxetine (Prozac®, Sarafem®, Fontex®)
  • Venlafaxine (Effexor or Efexor®) is an SNRI – serotonin and norepinephrine reuptake inhibitor
  • Paroxetine (Aropax®, Paxil®, Seroxat®, Sereupin®)

Used for: co-existing depression and anxiety also found to reduce migraines by affecting the level of the brain chemical serotonin. According to Emergency Medicine it is safe to use triptans and SSRI’s concomitantly.

Common side effects: gastrointestinal distress, tremor, weight gain or loss, decreased libido, and sexual erectile dysfunction (anorgasmia).

Beta Blockers

  • Propranolol (Inderal®, Timolol®)
  • Nadolol (Corgard®)
  • Metoprolol (Lopressor®)

Used for: high blood pressure and coronary artery disease. They are well tolerated and proven effective for migraine prevention.

Common side effects: cold hands, fatigue, depression, nausea, insomnia, dizziness and shortness of breath (asthma).

Calcium Channel Blockers

Migraine Prevention Medications Calcium Channel Blockers
  • Verapamil (Covera-HS®, Calaptin, Sinso,Tarka which is Verapamil and Trandolapril here in Australia )
  • Diltiazem (Cardizem, Cartia XT, Dilacor XR®, Tiazac)
  • and some of the anti-hypertensive medications: Lisinopril (Prinivil®, Zestril®) and Candesartan (Atacand®)

Used for: cardiovascular problems and the antihypertensive migraine prevention medications are used for reducing the length and severity of migraines. Evidence studies have found that they are more effective with cluster headaches rather than migraines.

Common side effects: drowsiness, ankle edema, weight gain, constipation, dizziness and low blood pressure.


  • Bayer Aspirin, Bufferin, Ecotrin, and Zorprin

Just to name a few. There are too many brands and forms of aspirin to list here.

Used for: to reduce fever and inflammation, colds and flu’s, headaches, and at 325 mgs has had good results with migraine incidence in men. It is recommended for people with migraine aura. Again – I have auras and no doctor has recommended Aspirin for me as a prophylactic. Hmmm....

Common side effects: heartburn; nausea; upset stomach. Warnings: avoid alcohol and it is not recommended for children (possible Reye's syndrome) or teenagers.

Severe allergic reactions for Aspirin are: rash; hives; itching; difficulty breathing or tightness in the chest; swelling of the mouth, face, lips, or tongue; black or bloody stools; confusion; diarrhea; dizziness; drowsiness; hearing loss; ringing in the ears; severe or persistent stomach pain; unusual bruising; and vomiting or vomiting blood.

Please note that this is not a complete list of all side effects that may occur. All the migraine prevention medications listed above will also have severe side effects – please contact your doctor or pharmacist ASAP if anything suspicious occurs.

If you have any questions AT ALL about the side effects you are experiencing please contact your health care provider ASAP. Call your doctor or talk to your local pharmacist for medical advice about side effects.

To report side effects to the appropriate agency, please click here for the FDA website guide to reporting drug related problems.

Botulinum Toxin A (Botox) Injections

Botox Injections for Migraines

Used for: wrinkles, chronic daily headaches over 15 days per month. This drug is injected into muscles at the sites of pain in the neck, face, and head in doses up to 100 units every 3 – 4 months.

Common side effects: mild pain, aching and bleeding at the site of injection, increase in headache condition, drooping eyelid, and dry mouth.

Please click on the links for more information on Botox for migraine headaches and Botox injection for migraine.

For Nausea

  • Metoclopramide (Other brand names are: Metozolv ODT, Reglan®)
  • Prochlorperazine (Brand name: Compazine®)
  • Promethazine (Brand name: Phenergan®)

Medications used to treat migraines also treat other ailments. They are not specific just for migraine treatment. Analgesics, narcotics, and barbiturates can be addictive, so they are used less in most instances by your doc.

Your doctor might try you on other drugs like a narcotic analgesic - Codeine (or Fioricet, or Tylenol#3) which can also be used as a "backup" for the occasions when a specific drug does not work.

This would be worth checking on it's own to see if it helps at all first.

My doctor separated Codeine out for me to use, it didn't touch the side of my pain, so I no longer take it.

This is good for me as it caused constipation. Who wants that?

Alternative Migraine Prevention Medications

Just in case you'd like a list of alternative migraine prevention medications like: bio-identical hormones, minerals, melatonin, vitamins and herbs, please click on these links to read a bit more about:

I hope you found this list of migraine prevention medications helpful.

More Ways to Prevent Migraines

The most widely recommended way to prevent migraines now, according to most studies, is to use biofeedback devices to help retrain your body.

I also found using ice and heat treatment a necessity to treat an acute attack. Read How to Treat a Migraine with ice and heat. 

But being proactive pays off too. These all work for me, give one a try.

What Have You Tried From This List?

Have you tried any of these medications? If you have, let me know in the Facebook comments box below. Success or failure, it is all a step forward.

Wishing you a pain free day,


1. MayoClinic.com Migraine (March 2015): Treatment and Drugs. Available at : http://www.mayoclinic.com/health/chronic-daily-headaches/ basic-treatments Accessed June 24, 2016.

2.Tepper, Deborah (2013) Prevention of Migraine. Headache: The Journal of Head and Face Pain. Available at: http://onlinelibrary.wiley.com/wol1/doi/10.1111/head.12191/full Accessed August 8th, 2016.

3. Teitelbaum, Dr. J. (2010) Magnesium for pain relief. Psychology Today: Complimentary Medicine. Available at: http://www.psychologytoday.com/blog/complementary-medicine/201009/magnesium-pain-relief Accessed June 12, 2016.

› What Migraine Prevention Medications Would You Choose From This List?

› What Migraine Prevention Medications Would You Choose From This List?

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