Prevention medications are taken daily to reduce frequency and severity of attacks — not for acute episodes but future protection.
When to Start Prevention:
- 4 or more attacks monthly.
- Severe attacks disrupting your life — even if fewer than 4.
- Acute medications don't work or cause side effects.
- Medication overuse headache (painkillers more than 15 days/month).
Common Medications:
- Propranolol (Inderal): Beta-blocker — first choice. 40-160mg daily. Safe and effective.
- Amitriptyline: Antidepressant at low dose — 10-50mg at bedtime. Also helps with sleep.
- Topiramate: Anti-epileptic — very effective. May cause weight loss (advantage for some).
- Candesartan: Blood pressure drug — good alternative if you can't tolerate others.
- CGRP injections (Erenumab): Newest treatment — monthly injection. Very effective but expensive.
Treatment Duration:
- Start low dose — increase gradually.
- At least 6 months — then assess to reduce or stop.
At BEIT TARIQ Center, we choose prevention medications based on your condition and other diseases.