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Migraine treatment in a nutshell
Which medication to use depends on the patient profile |
| Prophylactic Treatment |
 | Propranolol (Inderal LA) 60 mg bid, titrate up to 120 mg bid. Do not use in bradycardia, asthma. |
| Elavil 10 mg, titrate up as tolerated. Watch for sedation, weight gain, anticholinergic side effect. |
| Pamelor or Desipramine 25 mg hs, titrate up as tolerated. Watch for
drowsiness, anticholinergic side effect. |
| Topamax 25 mg bid, titrate up to 100 mg bid. Watch for drowsiness, tingling, weight loss. |
| Depakote 250 mg bid, titrate up as tolerated. Watch for weight gain, tremor.
Rare but can cause pancreatitis, thrombocytopenia. |
| More information |
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| Treatment of severe attacks |
| Naprosyn 500 mg prn po |
| Zomig Nasal spray or 2.5 mg zmt. 1 to 2 per 24 hours. |
| Migranal nasal spray: 1 spray into each nostril every 15 minutes, up
to
total of 4 sprays per attack. |
| Phenergan 25 mg po or suppository prn for nausea. |
| Reglan 10 mg prn for nausea |
| Stadol Nasal Spray 1 spray to nostril as last resort. Potentially
addictive. |
| More information |
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