Migraine Prophylaxis
Migraine is a condition that produces attacks rather than isolated headaches. An attack usually brings a severe throbbing headache, often on one side, together with nausea and a heightened sensitivity to light and sound. There is no cure, and treatment divides into settling an attack and preventing the next one. Prophylaxis is the preventive half: medicine taken every day with the aim of reducing how often attacks come and how severe they are.
Key points
- Preventive medicines act through different biological pathways, so which one suits depends on a person’s wider health.
- Full benefit can take several weeks to appear, and the choice is normally reviewed at the three-month mark.
- Success is measured by how far the number of attack days each month drops, not by attacks stopping altogether.
Who prophylaxis is for
Prevention is considered when attacks come often, last a long time, or respond poorly to treatment taken during an attack. It may also suit people whose migraines disrupt work or study, those who need acute relief medicines very frequently, and anyone with particular migraine subtypes.
Symptoms of an attack
A throbbing headache, often one-sided and worse on movement, is the core feature, alongside nausea or vomiting and marked sensitivity to light and sound. Some people notice warning symptoms before the headache begins, such as feeling very tired and yawning a lot.
Medicines that prevent attacks
Beta blockers and epilepsy medicines are the main groups used, and tricyclic antidepressants are often chosen when migraine coexists with poor sleep or low mood. Inderal tablets contain propranolol, a beta blocker, in 10, 20, 40 and 80mg strengths. Topamax tablets contain topiramate, an epilepsy medicine, in 25, 50 and 100mg strengths. Clonidine 0.1mg tablets are a further option. Pharmacy partners in India ship to Malaysia in discreet packaging.
What to expect, and when to get advice
Several weeks of use are needed before the full effect shows, and a combination of treatments may have to be tried before one works. Specialist referral is worth considering if attacks remain difficult to control, or if cardiovascular factors influence which medicine is suitable, since several of these agents also have a role in heart and blood pressure conditions.
What the sources say
- A migraine attack is a set of symptoms: a throbbing headache that can be severe and is often on one side, worse when you move around, with nausea and sensitivity to light and sound (NHS).
- Painkillers work best taken as soon as the headache starts (NHS).
- Preventive treatment includes beta blockers, antidepressants and medicines for epilepsy, along with acupuncture, relaxation techniques, CBT and vitamin B2 (NHS).
Further reading
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