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.
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Mold Illness vs. Allergies: What’s the Difference? When people think of mold, they often assume it just causes seasonal allergies—sneezing, itchy eyes, and runny noses. But mold illness goes far beyond typical allergic reactions, affecting multiple systems in the body and often mimicking chronic or autoimmune conditions. Mold Allergies: The Basics Mold allergies are an immune response to mold spores. Symptoms may include: Sneezing Runny or stuffy nose Itchy, watery eyes Cough or post-nasal drip Mild fatigue These symptoms usually flare up in humid environments, basements, or during seasonal changes. They’re often treated with antihistamines or allergy shots. Mold Illness: A Deeper Toxic Load Mold illness, also known as Chronic Inflammatory Response Syndrome (CIRS) , is triggered not by an allergic reaction, but by a toxic overload from mycotoxins —dangerous chemicals produced by certain molds . These toxins can accumulate in your body, especially if your detox pathways are compromised. Symptoms may include: Brain fog Chronic fatigue Digestive issues Hormonal imbalances Neurological symptoms like anxiety or depression Joint and muscle pain Key Differences Mold Allergy Mold Illness (CIRS) Involves histamine reaction Involves chronic inflammation Symptoms are seasonal or triggered by exposure Symptoms persist and worsen over time Usually treatable with OTC meds Requires detox, lifestyle changes, and medical treatment What If You Have Both? Some people suffer from both mold allergies and mold illness, making symptoms even more complex. If you’ve been treating allergies with little to no relief, it may be time to explore the possibility of deeper toxicity. If you have both mold allergies and mold illness, you will have to treat both. Remediate all mold out of your environment. Test for the presence of mold in your home and office environments. Remove high mold foods from your diet. What to Do Next If your symptoms go beyond allergy season and don’t improve with standard treatments, it’s time to consider mold testing and a functional approach to healing. At Your Inspired Vitality, we specialize in identifying and treating mold illness holistically. Detoxification strategies (sauna therapy, sweating, supplements, and binders), as well as dietary and environmental changes can help. Testing for the presence of specific mycotoxins is important to do as well and can be done through a simple urine test. Ready to feel better? Book a consultation today and let’s find out what’s really behind your symptoms.