Current medications used to prevent migraines are separated into a first, second, and third choice, a hierarchy of sorts that provides a flowsheet of what to do when some medications fail. It is not etched in stone, offered as a guideline only. Many physicians and headache specialists will mix or jump classes according to their own preferences or experience.
1. First choice includes
propranolol (beta-blocker), verapamil (Calan—calcium channel blocker),
amitriptyline (Elavil—antidepressant), and
topiramate (Topamax) and valproate (Depakene)—anti-seizure meds.
Pregnancy is a contraindication to valproate, which can cause birth defects. The beta-blockers shouldn’t be used in smokers or people over 60, which may raise the risk of stroke.
2. Second choice: for those who don’t respond adequately to the first-choice medications, there are
other beta blockers—atenolol (Tenormin), nadolol, metoprolol (Lopresor), timolol;
“Migraine” derives from the Latin word hemicrania (or heMICRANia), meaning “half the skull.” As early as the second millennium B.C., migraine headaches have been categorized as different from other types of headaches by their peculiar qualities:
Typically unilateral, although a third can involve both sides of the head.
Preceded by the migraine aura in a fourth of patients—a visual, olfactory (smell), or other sensory illusion that precedes or accompanies a migraine, but may occur even without a subsequent headache.
Throbbing, increased with movement or exertion
Pain builds up over a few hours.
Lasts from a few hours to three days
Associated with nausea and vomiting
Hypersensitivity to bright lights and sound
Statistics on Migraine
According to the Migraine Research Foundation , migraines affect a billion people worldwide as the 3rd most prevalent human disease. Most common between the ages of 25-55, children can also get them. ...