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Drug Treatment

#1

Drug therapy is usually prescribed at last resort, when all other more conservative approaches have been tried.

Prophylaxis

Prophylaxis is when you take a preventative medication constantly in a fixed pattern (e.g. a dose every evening).

It is usually applied when a sufferer experiences more than 2 migraines a month, although some of the drugs high level efficacy for treating the 24/7 symptoms may encourage a specialist to prescribe them regardless of the frequency of migraines.

Often drugs from one or more of these groups:

Rescue Medication

Is used for attacks and when symptoms or anxiety peaks.

Examples include:

  • Meclizine
  • Stemitil
  • Something from the Benzo family

Additional considerations for sufferers of SEH

Sometimes SEH sufferers will be asked to try diuretics, though a Cochrane review has not found definitive evidence for their efficacy.

Finding the right drug regime

Finding the right drug is a process of trial and error for most patients.

A great protocol is published on Dr. Hain’s excellent site, at the foot of this page.

He also has a great page on the drug treatment of vertigo here.

Find posts on Medication in our Medication Category

Please take a look at our User Poll for Meds to get an idea of what has helped members.

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#2

Here are some articles I have collected related to drug treatments.

How Different Antidepressants Work
How Antidepressants Work SSRIs, MAOIs, Tricyclics, and More.pdf (153.3 KB)

Guidelines for Switching Between Specific Antidepressants
Switching-antidepressants-A3-poster.pdf (53.1 KB)

Lighting
#3

I recently found a site that has a list of a variety of drugs that are used to treat migraine. It’s worth looking at:
http://www.helpforheadaches.com/articles/prev-meds.htm 1

Here’s their list:

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:

  • Memantine, aka Namenda

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:

  • Celecoxib, aka Celebrex

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:

  • Baclofen, aka Lioresal
  • Botulinum Toxin Type A, aka Botox
  • Memantine, aka Namenda

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