Migraine Preventatives

ineedacoffee222 · 2025-04-13T07:14:34+00:00

Hi, what migraine prevention treatment have you tried & had success with minimal side effects? I’ve tried a couple of things but the side effects weren’t great so have a GP appt on Tuesday to discuss. Interested to hear what has worked best for you. Thanks!

PaintDecisions · 13/04/2025 08:30

https://cks.nice.org.uk/topics/migraine/management/adults/#preventive-treatment

Have a read of that, it's the guidance your GP will use.

For me though, over 25yrs:

Propranolol - no side effects, but also no migraine improvement. Pointless.
Pizotifen - side effect of nightmares every night, really weird, but highly effective on migraine numbers
Topiramate - awful side effects, nearly cost me my job and my marriage, was being tested for blood cancers and other things because I was such a mess. Do not recommend. Also whilst it was initially effective on migraines, it ended up being useless at the highest dose and absolutely not worth the side effects
Amitriptyline - side effect of drowsiness, couldn't get past this and shake it off, it was too sedating for me and dangerous (police officer), didn't last long enough on it to know it was effective.
Botox - didn't like the frozen forehead. 42 injections across the face, head and back. Halved my migraine days from 27 to 15 per month. Reduced the severity as well.
Ajovy and Aimovig - no real side effects. Reduced migraine days to approx one a week. Life changing. Also sorted my IBS as it slows down gut motility.

Pastlast · 13/04/2025 08:45

Amitriptyline Worked for the pain but not the exhaustion.

My game changer was a night guard to stop me grinding my teeth. It turned out this was what was causing 85% of my migraines.

AnnaMagnani · 13/04/2025 08:57

Amitriptyline - didn't suit me, one dose and I was comatose
Propranolol - skipped this as I have asthma
Lisinopril - skipped as I have low blood pressure
Topiramate - worked but needed a higher dose and the side effects began to interfere with work, if that was all that was I would have stuck with it though, the side effects were a mild and a lot better than the migraine
Cephaly - bought myself, definitely helped (and no side effects)
Acupuncture - better than nothing when you are stuck without a triptan
Botox - paid for it myself, brilliant but still migraines

Other things that helped:
Mini-pill - eradicated menstrual migraines
Mouthguard - reduced general tension in my face as I'm a terrible tooth grinder
A lot of migraine related lifestyle changes: same time getting up, same time going to bed, minimal alcohol, minimal caffeine, blue light filters on all screens
Physio to my neck and shoulders

Having gone through all this I was eligible for a neurology appointment:
Aimovig - like an actual miracle although I do get the weird dream side effects

The GP should have access to their local guidance on migraine pathway and all the things they can try in primary care.

My neurologist has migraine and told me he takes an enormous dose of propranolol and is very happy with it.

Basically there is something out there for everyone, most people find their 'something' before needing Aimovig, and one person's side effect nightmare is another's dream drug.

Rocknrollstar · 13/04/2025 09:31

I gave up cheese, eggs, red wine and chocolate.

Sadcafe · 13/04/2025 09:37

Pizotifen was the only thing that ever successfully reduced the number and severity of migraine but put on a significant amount of weight with it

TheCountessofFitzdotterel · 13/04/2025 09:39

Feverfew, giving up chocolate and being careful to avoid flashing lights.

Imperfectpolly · 13/04/2025 09:44

Propanolol dramatically reduced mine. I take 80mg in the morning and 40mg in the evening. I had side effects for the first couple of weeks and then they wore off.

AlwaysFreezing · 13/04/2025 09:56

I had a long course of topirimate. The side effects were bad initially. And working up through the doses to get to the highest dose was hard going. But. Once I got to the desired dose the side effects evebtually stopped. I kept going until I had the required amount of time migraine free and then started the same journey in reverse for weaning off them. I went from weekly debilitating migraines to one maybe 2 a year. That was about 10 years ago and I still don't suffer. So for the pain of 4 months of feeling like shit with side effects it has been totally worth it for me.

Mine were cervical migraines as well as regular ones. I would barely be able to use my arms. It was so weird. The other thing I did, on the advice of the neurologist was to only sleep on one pillow. Now that was hard to adjust to! But I cracked it and now only sleep on one. That may well have helped too! (I edited my post to add the pillow details!)

Conqueeftador · 13/04/2025 10:05

I take amitriptyline and it’s worked fantastically for me. The first couple of weeks were hard, as it made me really drowsy, but that wore off and hasn’t been an issue since. It was worth the adjustment time for the result.

Good luck finding something that works for you.

mechanicalpencil · 13/04/2025 10:08

Conqueeftador · 13/04/2025 10:05

I take amitriptyline and it’s worked fantastically for me. The first couple of weeks were hard, as it made me really drowsy, but that wore off and hasn’t been an issue since. It was worth the adjustment time for the result.

Good luck finding something that works for you.

@Conqueeftador what is your dosage please?

mechanicalpencil · 13/04/2025 10:11

Hello OP
Migarines are awful.
I have tried so many things over the decades but currently on Amitriptyline 10mg - to be honest, I have seen very little change and none at all with the horrendous hormonal migraines. So my GP has suggested increasing the amitripytline from 10mg to 20 mg and also starting on the mini pill/ progesterone pill…
I haven’t made these last 2 changes yet.

OneCoralHare · 13/04/2025 10:14

Rizatryptan mostly works for me. I take it as soon as I get symptoms and if I take it early enough, the symptoms pass in about twenty minutes and don’t turn into a migraine.

PaintDecisions · 13/04/2025 10:18

OneCoralHare · 13/04/2025 10:14

Rizatryptan mostly works for me. I take it as soon as I get symptoms and if I take it early enough, the symptoms pass in about twenty minutes and don’t turn into a migraine.

That's an abortive med (triptan), not a preventative one.

AnnaMagnani · 13/04/2025 10:24

@OneCoralHare there's a limit on how many triptans you can have a month to treat individual headaches before you start triggering overuse headache.

It's usually 6 a month.

Not a lot of use if your typical migraine lasts 4 days and you have them every week 😥

Notgoodatpoetrybutgreatatlit · 13/04/2025 10:29

I had that injection in the back of the head a few times. I had to have it on both sides. It made me feel as if I had a bit of sunburn but it worked for about 8 weeks. It was painful but not as painful as migraine.
My lovely nurse consultant told me about the new drugs and I'm now taking atogepant everyday. They aren't available on NHS and cost plenty of money, about £250 a month, but they work pretty much all the time. I think I've had about 6 migraines in a year instead of 6 a week.
I am so grateful both that the drug exists and that I can afford it.
Nothing I gave up food wise worked. Although I can't drink alcohol. I cant cope with bright flickering sunlight, like through trees through a train window to this day.

AnnaMagnani · 13/04/2025 10:33

Food wise, being hungry was one of my major triggers. I put on stones and stones of weight trying to eat my way out of migraines.

In terms of specific foods, I find that I start craving chocolate and carbs in the pro-drome of a migraine. The chocolate doesn't trigger the migraine as by the time I'm eating it, the migraine is inevitable.

PaintDecisions · 13/04/2025 10:35

Notgoodatpoetrybutgreatatlit · 13/04/2025 10:29

I had that injection in the back of the head a few times. I had to have it on both sides. It made me feel as if I had a bit of sunburn but it worked for about 8 weeks. It was painful but not as painful as migraine.
My lovely nurse consultant told me about the new drugs and I'm now taking atogepant everyday. They aren't available on NHS and cost plenty of money, about £250 a month, but they work pretty much all the time. I think I've had about 6 migraines in a year instead of 6 a week.
I am so grateful both that the drug exists and that I can afford it.
Nothing I gave up food wise worked. Although I can't drink alcohol. I cant cope with bright flickering sunlight, like through trees through a train window to this day.

Atogepant is indeed available on the NHS and has been since April 2024.... Might be worth finding out if you can get it via an NHS neurologist.

Notgoodatpoetrybutgreatatlit · 13/04/2025 11:29

I am booked to see her soon so it would be a double miracle if it was now NHS, it would make me richer as well as migraine free!

Ener · 13/04/2025 11:33

I got my daith piercing for migraine and only get one a year now rather than monthly

Merluzzo · 13/04/2025 11:35

I take Pizotifen and it works for me, with few side effects.

KaySam · 13/04/2025 12:51

Notgoodatpoetrybutgreatatlit · 13/04/2025 10:29

I had that injection in the back of the head a few times. I had to have it on both sides. It made me feel as if I had a bit of sunburn but it worked for about 8 weeks. It was painful but not as painful as migraine.
My lovely nurse consultant told me about the new drugs and I'm now taking atogepant everyday. They aren't available on NHS and cost plenty of money, about £250 a month, but they work pretty much all the time. I think I've had about 6 migraines in a year instead of 6 a week.
I am so grateful both that the drug exists and that I can afford it.
Nothing I gave up food wise worked. Although I can't drink alcohol. I cant cope with bright flickering sunlight, like through trees through a train window to this day.

I have the atogepant through my neurologist on the nhs. So I would query that

KaySam · 13/04/2025 12:52

I’ve had ajovy for a few years but it stopped working as well as it did previously so now I am back on Botox every 12 weeks and atogepant tablet daily.

Conqueeftador · 13/04/2025 12:53

mechanicalpencil · 13/04/2025 10:08

@Conqueeftador what is your dosage please?

Show quote history

I’m on 30mg. I started on ten, then increased by 10 more a couple of times over a few weeks. I was a bit worried it would make me really drowsy again when I upped the dose, but that didn’t happen thankfully. I’ve been on it for a few years now, and it’s made such a huge difference. Very rarely get one now, and if I do they tend not to last too long. My GP had said up to 50mg would be what she was happy with, after that she said if it didn’t work then I’d need to see a neurologist, but 30mg seems to be the dose for me.

HundredMilesAnHour · 13/04/2025 12:59

Amitriptyline worked well for me. No side effects at all. Surprised that others are reporting drowsiness on it but I have ADHD so I’m very hard to knock out. 😛😂

Moonsonetime · 13/04/2025 13:01

75mg aspirin before intense exercise.
Massage gun my neck and head base if any tension.
3x300mg aspirin at the first whiff of migraine normally stops them.

All tips from the hospital headache clinic that work for me.