Using preventive medication on a daily basis to help raise the headache threshold and diminish headache frequency and intensity. These medications are found in six categories of medications that have mostly been found by chance to help prevent migraine by raising the migraine threshold. This includes:
- Natural supplements to include Magnesium, Riboflavin and Co-Q 10. These are ideally formulated in Ribo-Mag forte that has demonstrated excellent results
- Seizure medications such as Topiramate, Valproate, Zonisamide
- Cardiac type meds such as beta-blockers, calcium channel blockers and angiotensin receptor blockers
- Anti-depressant category such as tricyclics and SSNI/SSRI combination products are often effect even if the person has no evidence of depression. However, depression and sleep disturbances are very common association with migraine due to the serotonin disturbances so these medications can help with migraine prevention as well as the depression and sleep disturbance.
- Botulinum toxin injections: Dr. Hogan has been utilizing Botox injections for over 20 years and more recently other forms of botulinum toxin injections for treatment of migraine as part of the long term process that finally led to Botox being formally approved by the FDA in November, 2010 for prevention of chronic migraine. Lelise Casias is also skilled at utilizing BOTOX for migraine.
- Anti-CGRP therapies: CGRP is a protein released in the brain that is now know to contribute to migraine symptoms and pain. The first anti-CGRP therapy was FDA approved in 2019. The class now has 4 approved medications that are offering patients relief from both episodic and chronic migraine.