Medication Prevention and Advanced Options

If non-drug measures aren't enough and you have at least three to four or more migraine days per month, a medication-based prophylaxis may be worthwhile. Several drug classes — not painkillers themselves, but proven effective in large patient studies — are approved for daily use, typically for around 6-12 months: beta blockers, flunarizine, topiramate, and amitriptyline.

Chronic migraine

In phases with very high attack frequency — chronic migraine, defined as at least 15 headache days per month for more than 3 months — botulinum toxin (Botox) injected at defined points has proven effective as a further option.

CGRP antibodies

A newer treatment option is CGRP antibodies (erenumab, galcanezumab, fremanezumab), which patients inject themselves under the skin every 4 weeks. These modern medications should only be used once conventional treatments listed above have failed, or caused side effects that prevented regular use.