Many preventive migraine medications exist. Some examples include angiotensin-converting enzyme (ACE) inhibitors, anticonvulsants, beta-blockers, and calcium channel blockers.

Not every medication is right for every person, so individuals should always talk with a doctor to determine which migraine prevention method might work best for their needs.

The following article discusses some migraine prevention medications, the benefits of each, and more.

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ACE inhibitors help blood vessels and veins relax. This can help lower blood pressure, which may be helpful in preventing migraine.

However, these medications may not be the best choice for migraine prevention.

According to a 2019 review of studies, ACE inhibitors can be effective in reducing the number or frequency of headaches in people with migraine. However, due to the limited number of studies and small sample sizes, they may not be a good first choice for migraine prevention.

Nevertheless, the review also notes that people with comorbidities, such as high blood pressure, may find them helpful as a first or second line of treatment for migraine prevention.

Learn more about ACE inhibitors here.

Doctors typically prescribe anticonvulsants, or antiepileptic medications, to people living with epilepsy disorders. Researchers believe that these medications may work by reducing or calming activity in the brain.

According to the American Migraine Foundation (AMF), doctors often prescribe these medications for migraine prevention.

One 2016 study suggests that both topiramate and divalproex sodium may help with migraine prevention. However, researchers do not fully understand how they work to prevent migraine episodes.

The study notes that although people can use these medications as a first or second treatment option, doctors should consider the potential side effects and whether or not a person has other conditions before prescribing anticonvulsants for migraine prevention.

Beta-blockers are a type of medication that doctors usually prescribe for high blood pressure. People with migraine who also have high blood pressure or another condition that increases their blood pressure may find beta-blockers helpful for migraine prevention.

Some research suggests that beta-blockers, such as propranolol, effectively prevent episodic migraine because of their blood pressure-lowering effect. They may also help with chronic migraine or tension headaches, but there is less evidence to support this claim.

In a 2019 study, researchers found that propranolol and metoprolol can both help with reducing migraine headache frequency.

Learn more about beta-blockers here.

Doctors typically prescribe calcium channel blockers to help with heart-related conditions, such as high blood pressure.

These drugs modify how calcium ions move into the blood vessels, which can stop the vessels from changing. By preventing a change in blood vessels, calcium channel blockers may help prevent migraine or cluster headaches.

According to the National Headache Foundation, the Food and Drug Administration (FDA) has not approved calcium channel blockers for use in migraine prevention. However, a person with heart-related problems may find that these medications can help with both conditions.

Learn more about calcium channel blockers here.

According to one 2019 review, calcitonin gene-related peptide (CGRP) plays a crucial role in migraine. CGRP increases during an episode. CGRP-blocking medications, such as Aimovig, can help prevent the buildup of CGRP, which may reduce the frequency of migraine headaches each month.

The review authors also note that, for most people, CGRP-blocking medications are generally safe and effective in preventing migraine.

According to the AMF, the FDA first approved CGRP medication in 2018. It notes that a person who usually experiences several severe migraine headaches each month could see a significant improvement in the number of headache-free days they experience per month and year.

Neuromodulation devices can provide migraine relief by increasing or decreasing activity in the nervous system. These devices work by delivering electrical or pharmaceutical stimulation to the nerves.

A doctor may prescribe the use of a neuromodulation device to both prevent and treat migraine episodes. Most of the available devices are prescription-only, but the FDA has approved one for over-the-counter use.

According to the AMF, these devices are a suitable choice for people who do not tolerate migraine medications or cannot take certain medications due to other health concerns. However, like other interventions, this option may not work for everyone.

Supplements may refer to minerals, vitamins, and other substances. People typically take these to promote their overall health or fill nutritional voids in their diet.

Although some people use supplements to help manage migraine, there is limited evidence to suggest that they are helpful for this purpose.

In an older study from 2009, researchers did note that supplements including one or more of the following may help people manage migraine:

  • magnesium
  • alpha-lipoic acid
  • Petasites hybridus
  • coenzyme Q10
  • riboflavin
  • feverfew

However, to prevent potential interactions, a person should talk with a doctor before taking a new supplement — especially if they are already taking other supplements or medications.

Doctors often prescribe tricyclic antidepressants for the treatment of depression. However, these medications might also be effective in the treatment of migraine.

Tricyclic antidepressants, such as amitriptyline, work by changing the levels of chemicals in the brain. This type of antidepressant may be more effective than other antidepressants in managing migraine.

However, research from 2017 suggests that tricyclic antidepressants may be effective but that people often do not tolerate them well. The review also notes that people taking certain types of tricyclic antidepressants, including amitriptyline, were more likely to stop their treatment due to experiencing adverse reactions.

Doctors sometimes prescribe selective serotonin reuptake inhibitors (SSRIs) and serotonin‐norepinephrine reuptake inhibitors (SNRIs) for the prevention of migraine.

Doctors usually prescribe these medications for depression. They work by affecting the levels of certain chemicals, such as serotonin, in the brain.

However, according to a 2015 review of studies, researchers do not recommend the use of SSRIs and SNRIs for the treatment or prevention of migraine. The authors found that most studies showed that the medications were no more effective than placebos at preventing migraine.

Learn more about SSRIs and SNRIs here.

People do not always tolerate medications for migraine well. A person living with migraine may struggle to find a medication or combination of medications that effectively prevents migraine.

As a result, they may turn to other therapies that may help with migraine prevention. These other therapies may include the following.

Botox

In 2010, the FDA approved the use of Botox to treat chronic migraine. Botox blocks the nerves and pain receptors near the injection site.

The injections have approval for use in adults over the age of 18 years who have more than 15 migraine headaches each month.

Learn more about Botox here.

Acupuncture

Regular acupuncture sessions may help reduce migraine headache frequency.

According to a 2017 review of studies, regular treatment with whole-body acupuncture may effectively reduce the number of headaches a person experiences per month.

Learn more about acupuncture here.

Some research suggests that keeping a food diary may help a person reduce their exposure to migraine food triggers. People can use a food journal to record what they eat and note when they get migraine headaches.

According to the AMF, other anecdotal treatments — such as essential oils — may not be effective. Before using any supplements or other natural remedies, a person should discuss their plans with a doctor to make sure that they will not interfere with their other medications.

Learn more about natural remedies for migraine relief here.

Many medications for migraine prevention are prescription-only, which means that a person will need to discuss them with a doctor first. A person should work with a doctor or neurologist to determine which medication or combination of medications may work best for them.

Some factors to consider include:

  • other conditions that a person may have
  • other medications the person is taking
  • treatment costs
  • possible benefits
  • possible side effects

Most medications for migraine prevention are prescription-only. In other words, a person needs to have a prescription from a doctor to gain access to a medication.

Doctors may recommend a number of potential options for migraine prevention. The choice of medication may come down to whether or not a person experiences side effects, the medication’s effectiveness, other conditions the person has, and any other medications the person is taking.

A person should work with a doctor to determine the best medication for them.