Preventive Migraine Medications: Generic and Brand Name Treatment Options
Evangeline Lindorf
What to try before trying Botox shots for your migraines
Migraines can be a real pain—literally! But did you know there are medications you can take regularly to help prevent them? In this post, I’ll discuss different types of preventive medications that can make a huge difference for those who suffer from frequent migraines. Let's break down what these medications are, how they work, and what side effects you might encounter.
It’s also important to note that before insurance will cover injectable medications (such as monthly preventative injections or Botox shots), you will need to try and fail–or have medical contraindications to trying–medications from each of these 3 categories. This is not an all inclusive list. After you have done a trial of medication from each of these first 3 categories insurance will typically cover quarterly Botox shots or monthly injectables including Aimovig, Ajovy, or Emgality. Note that some insurance companies require trials of additional antidepressants such as Effexor etc., and not just tricyclic antidepressants.
Category 1: Antiseizure Medications–Topiramate, Gabapentin, and Pregabalin
These medications are usually used to treat seizures, but they can also help prevent migraines. They work by calming down the nerve activity in your brain, which can help stop migraines before they start. Some common side effects include feeling dizzy or tired and changes in weight.
Category 2: Tricyclic Antidepressants Medications–Amitriptyline and Nortriptyline
These are types of antidepressants, but they can also be used to prevent migraines. They work by balancing certain chemicals in the brain that affect pain. You might experience a dry mouth, feel sleepy, or notice some weight gain when taking these.
Category 3: Blood Pressure medications–Propranolol and Verapamil
These medications are typically used to lower blood pressure, but they can also help with migraines. They relax your blood vessels, improving blood flow and reducing the chances of a migraine. Some side effects could be feeling tired, dizzy, or having lower blood pressure.
Monthly Injectable Medications: Ajovy, Aimovig, and Emgality
These are newer migraine prevention treatments. They work by blocking a molecule that triggers migraines. You take them as injections, and they can significantly reduce how often you get migraines–most patients see a 50% reduction in monthly migraines! Common side effects include injection site reactions (redness, itching) and more rarely constipation.
Understanding these preventive options can help you manage your migraines better.
In next week's post, I'll talk about quick-relief rescue treatments for migraines, including triptans (Sumatriptan, Rizatriptan) and gepants (Nurtec, Ubrelvy), and how to handle their side effects. We will also discuss Qulipta
in the next post.
Safe Exercise for People with Hypermobility Ehlers-Danlos Syndrome (hEDS) If you’ve been diagnosed with hypermobility Ehlers-Danlos Syndrome (hEDS) , you know that movement can feel tricky. Joints may slip, ache, or feel unstable, and sometimes exercise feels intimidating and overwhelming. However, the right kinds of exercise will help you get stronger, protect your joints, and improve your daily comfort. The goal with hEDS is not to push your body to extremes—it’s to gradually, over time, build gentle strength, stability, and confidence. Why Exercise Matters with hEDS The right types of movement can: Strengthen muscles that support loose joints. Improve balance and body awareness (reducing injury risk). Ease pain and fatigue. Boost mood and energy. Nurse Pro Tip : Think “support” not “stretch.” The goal isn’t more flexibility—you already have plenty—but stability and protection. ✅ Safe & Helpful Exercises When choosing activities, think slow, steady, and supportive. 💧 Water-Based Exercise Swimming, water walking, or gentle aquatic therapy take pressure off your joints while still giving you resistance to build strength. 🧘 Modified Pilates or Yoga Focus on core strength and stability. Skip deep stretches—keep movements small, controlled, and steady. 🏋️ Light Strength Training Resistance bands or light weights help build protective muscle. Stick with lighter loads, higher reps, and slow, intentional movements. 🚶 Walking or Cycling Flat-ground walking and recumbent cycling are gentle, low-impact ways to support cardiovascular health. 🤲 Physical Therapy Exercises A physical therapist who understands hEDS can teach you safe, customized strengthening routines to stabilize your most vulnerable joints. ( Email me @ yourinspiredvitality@gmail.com for personalized recommendations or referrals to Utah PTs familiar with hEDs). ❌ Exercises to Avoid Some activities can increase the risk of injury or worsen symptoms. It’s best to avoid: High-impact sports (running, jumping, contact sports). Heavy weightlifting (places too much strain on joints). Deep stretching or “contortion-like” yoga. Fast-paced HIIT workouts with explosive movements. Gymnastics or flexibility-focused training. Nurse Pro Tip : If the focus of a workout is “how far you can stretch” or “how heavy you can lift,” it’s probably not the right fit for hEDS. 💡 Tips for Moving Safely Listen to your body—stop if something feels wrong. Prioritize stability, not flexibility. Work with professionals who understand hypermobility. Progress slowly—small, consistent steps are safest. ✨ The Bottom Line -- Living with hEDS doesn’t mean avoiding exercise. It means finding the right kind of movement that supports your body instead of stressing it. With gentle, strengthening exercises, you can feel stronger, reduce pain, and enjoy a more active, confident life.
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