These are old standbys in headache prevention because they help address any elevations in blood pressure, they are typically inexpensive, and beta-blockers can be effective in reducing anxiety, which is not an uncommon problem in migraine patients. The most evidence favors the beta-blockers metoprolol, propranolol, and timolol, followed by atenolol and nadolol. Propranolol and timolol have

US Food and Drug Administration (FDA) approval for migraine prevention; the others do not. Should beta-blockers not be advised, for example in very athletic patients, or those with Raynaud’s (spasm of the arteries in the fingers with cold) or asthma, the angiotensin-converting enzyme inhibitor lisinopril, or the angiotensin receptor blocker candesartan, may be useful. For those who have heard that calcium channel blockers, such as verapamil, may help prevent migraine, GSK2126458 solubility dmso the most recent guidelines did not find strong evidence to support their effectiveness. This group of medications can be equally as effective as beta-blockers, depending on which ones buy Dabrafenib are chosen. Divalproex sodium and sodium valproate (often called Depakote) is a long-standing and effective preventive agent. Generally, it is well tolerated too, but can be associated with weight gain, can affect the ovaries, can cause birth defects, and should be avoided by those with liver disease.

Topiramate is another effective preventive medication. While it can result in tingling, word finding problems, and memory issues, its most beloved side effect is the potential for weight loss. Both valproate and topiramate are FDA-approved for migraine prevention. Other selleck chemical common medications for prevention, such as gabapentin and lamotrigine, lacked sufficient evidence for being effective. Amitriptyline is an old, inexpensive medication and effectively prevents episodic migraine. While it can help with sleep and mood, it can result in weight gain, sedation, and dry mouth. A newer antidepressant that made it to the preventive

list is venlafaxine, which helps with mood and does not result in weight gain. It is usually taken in the morning and can be energizing, so it does not help people fall asleep. Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) work well for depression and anxiety, but lack strong evidence supporting effectiveness as migraine preventives. The supplement group is usually well tolerated by most people, although the effectiveness may not match stronger prescription counterparts. Petasites (butterbur) was found to be effective as a preventive. Riboflavin, magnesium, and MIG-99 (feverfew) are probably effective, and CoQ10 is possibly effective. There is only one FDA-approved medication for preventing chronic migraine, defined as headache at least 15 days per month at least 4 hours per day.