The Top 10 Prophylactic Treatments for Migraines

In a recent post, I listed the top 10 acute treatments for migraine attacks that are mentioned in my book, The End of Migraines: 150 Ways to Stop Your Pain. Here is a list of the top 10 preventive drug therapies for migraines. In the next post, I will list the top 10 non-drug therapies.

The order of choices can vary depending on co-morbidities, potential side effects, cost, and other factors. For example, patients with coexistent anxiety and/or depression would have duloxetine and nortriptyline move higher on this list. Patients with rapid heartbeat, anxiety, or PTSD could start with nebivolol. Those with high blood pressure, could start with candesartan or nebivolol, and so on.

1. OnabotulinumtoxinA (Botox)
2. Atogepant (Qulipta)
3. Rimegepant (Nurtec)
4. Galcanezumab (Emgality)
5. Nebivolol (Bystolic)
6. Propranolol (Inderal)
7. Candesartan (Atacand)
8. Duloxetine (Cymbalta)
9. Nortriptyline (Pamelor)
10. Fremanezumab (Ajovy)