Prevention options: there’s four standard categories. Some of them have FDA approval and some don’t, and that’s mainly because we use them clinically but the companies that had the drugs either didn’t seek FDA approval or the medications are just too old to have bothered to go to the FDA for FDA approval. You may hear of antidepressants, most specifically tricyclic antidepressants – very low doses. These are very commonly used to treat migraine. At night, amitriptyline or nortriptyline, usually. Beta blockers – Propranolol is probably my favorite but you may hear of Atenolol or Metoprolol. Again: pretty low doses because in higher doses those can have side effects. Seizure medications, so these are anti-seizure medications that have some properties (again, at lower doses) to help with migraine. Typically Topiramate, Depakote, or sometimes Gabba Penton. And then the last one (and this is actually typically my last choice, although it works fantastically) is botox. The reason is that it’s fairly invasive. It requires multiple injections and multiple appointments.
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