Chapter 015. Headache (Part 12)

Table 15-7 Preventive Treatments in Migrainea Drug Dose Selected Side Effects Pizotifenb mg qd 0.5–2 Weight gain Drowsiness Beta blocker Propranolol 40–120 mg bid Reduced energy Tiredness Postural symptoms Contraindicated in asthma Tricyclics Amitriptyline 10–75 mg at night Drowsiness Dothiepin 25–75 mg at night Nortriptyline 25–75 mg at night Note: Some patients may only need a total dose of 10 mg, although generally 1–1.5 mg/kg body weight is required Anticonvulsants Topiramate mg/d 25–200 Par

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Chapter 015. Headache (Part 12) Table 15-7 Preventive Treatments in Migrainea Drug Dose Selected Side Effects Pizotifenb 0.5–2 Weight gain mg qd Drowsiness Beta blocker
Propranolol 40–120 Reduced energy mg bid Tiredness Postural symptoms Contraindicated in asthma Tricyclics Amitriptyline 10–75 Drowsiness mg at night Dothiepin 25–75 mg at night Nortriptyline 25–75 Note: Some patients may only need mg at night a total dose of 10 mg, although generally 1–1.5 mg/kg body weight is required
Anticonvulsants Topiramate 25–200 Paresthesias mg/d Cognitive symptoms Weight loss Glaucoma Caution with nephrolithiasis Valproate 400– Drowsiness 600 mg bid Weight gain Tremor
Hair loss Fetal abnormalities Hematologic or liver abnormalities Gabapentin 900– Dizziness 3600 mg qd Sedation Serotonergic drugs Methysergide 1–4 mg Drowsiness qd Leg cramps Hair loss
Retroperitoneal fibrosis (1-month drug holiday is required every 6 months) Flunarizineb 5–15 Drowsiness mg qd Weight gain Depression Parkinsonism No convincing evidence from controlled trials Verapamil Controlled trials demonstrate no effect Nimodipine
Clonidine SSRIs: fluoxetine

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