Migraine prophylaxis

Migraine prophylaxis is treatment intended to reduce the frequency or severity of future migraine attacks. It includes medications and behavioral or procedural approaches, chosen according to migraine burden, risks, and patient preferences.

Topiramate: An anticonvulsant medication also used to prevent migraine attacks. A commonly used oral preventive, especially when attacks are frequent.
Calcitonin gene-related peptide: A signaling molecule involved in pain transmission and migraine attacks. Several newer preventives reduce signaling through this migraine-related pathway.
Migraine: A neurological disorder characterized by recurrent attacks of headache and associated symptoms. Prophylaxis aims to reduce the burden of this disorder, not treat an attack in progress.
Acute migraine treatment: Treatment taken to relieve an ongoing migraine attack or its symptoms. Unlike prophylaxis, acute treatment targets attacks already underway.
Propranolol: A beta blocker used to treat high blood pressure and prevent migraine attacks. An established preventive option that can also address hypertension.
Cortical spreading depression: A slowly propagating wave of altered neural activity associated with migraine aura. Its biology helps explain aura and informs research into attack prevention.
Chronic migraine: Migraine occurring on at least 15 headache days monthly for over three months, with migraine features on at least eight days. This frequent pattern affects preventive choices and eligibility for certain treatments.
Migraine trigger management: Strategies for identifying and addressing factors associated with migraine attacks. Trigger management can complement prevention but does not replace preventive treatment when needed.
Amitriptyline: A tricyclic antidepressant used for depression, pain conditions, and migraine prevention. May suit people whose migraine coexists with sleep problems or chronic pain.
Trigeminal nerve: A cranial nerve carrying facial sensation and pain signals from the head. Many migraine preventives affect pathways that transmit signals through this nerve.

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