How to PREVENT  Headaches

Supplemental Vitamins with Potential to Prevent Headaches

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Some vitamins that can help to prevent headaches. If you're pregnant or may become pregnant, please discuss the supplements with your physician before starting them.

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• Magnesium:

  • Using magnesium glycinate, oxide or citrate (400-600 mg daily, taken with food) was found to have 40-90% average headache reduction when used as a preventive.

    • If you experience gastrointestinal side effects while using magnesium oxide, try switching to magnesium glycinate or citrate.​

  • Magnesium also demonstrated benefits in reducing menstrual headaches.

  • Good sources of magnesium include nuts, whole grains, and tomatoes.

  • There's controversy over whether this is safe in pregnancy, although it's been used safely in oral form for decades in pregnancy.

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• Coenzyme Q10 (CoQ10):

  • Doses of 300-400 mg daily have been shown to be effective at reducing headache frequency.

    • CoQ10 can reduce the frequency of headaches by improving the energy production of cells.

  • This medication is NOT safe if you're taking warfarin (Coumadin), which is used to prevent or treat blood clots.

  • There is uncertain safety in pregnancy.

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• Riboflavin (Vitamin B2):

  • ​A dose of 400 mg daily is suggested to decrease headache frequency. 

  • This vitamin assists nerve cells in the production of a principal energy-storing molecule. It is necessary for many chemical reactions in the body.

  • Riboflavin can also be obtained by eating bread, cereal, milk, meat and poultry.

  • Riboflavin deficiency isn't necessary for the supplements to help prevent headache.

  • This supplement is safe in pregnancy.

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• Melatonin:

  • Melatonin may also reduce the intensity and length of headaches.​

  • It is often used to help people sleep and good sleep is important in managing headaches.

  • It's recommended to start with 3 mg of melatonin two hours before going to bed. If you experience cluster headaches, higher doses (up to 15 mg) might be helpful.​

  • Melatonin can help to restore balance in the bodies internal clock, which can often be disrupted by headaches. 

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Prescription Medications to Prevent Headaches

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​If you have four+ days with headaches per month, then you may want to consider a headache prevention medication. These are medications taken on a daily basis and do not cause rebound headaches. The goal of these medications is to reduce how often you get headaches.​ There are many classes of medications like blood pressure medications, seizure medications and mood-stabilizing medications that are prescribed to prevent headaches. Headache treatment is personalized to each patient, so your doctor can help you identify which one might be best for you. ​

 

• Blood pressure medications:

  • Propranolol (Inderal): Commonly used to prevent headaches. It's also considered a beta-blocker, making it suitable to treat conditions such as high blood pressure, irregular heartbeats, chest pain, and tremors.

  • Metoprolol (Lopressor, Toprol): Commonly used to prevent headaches. It's also considered a beta-blocker and is beneficial for treating chest pain, heart failure, and high blood pressure and for preventing stroke, heart attack, and kidney problems.​

  • Candesartan (Atacand): Shown to be effective in preventing headaches. It's also considered a beta-blocker, so it's used to treat high blood pressure and heart failure.

  • Nadolol (Cogard): Often used to prevent headaches, especially for patients who do not tolerate or respond well to other blood pressure medications, like propranolol. It's also considered a beta-blocker, so it's suitable for treating high blood pressure and chest pain.

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• Seizure medications:

  • Topiramate (Topamax): This medication is commonly used to prevent headaches in adults and is also frequently used to treat various types of seizures in adults and children.​

  • Valproate (Depakene, Stavzor): Used to help prevent headaches in adults and is also used to treat various types of seizures and manage bipolar disorder.

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• Mood stabilizers:

  • Nortriptyline (Pamelor): This medication is commonly used to prevent headaches. It's also an antidepressant, which can be used to treat symptoms of depression, anxiety, or neuropathic pain.

  • Amitriptyline (Elavil): This medication is commonly used to prevent headaches. It's also an antidepressant and is also used to treat depression, anxiety, or neuropathic pain.

  • Venlafaxine (Effexor): This medication is often used as a preventative treatment for headaches. It can also be used to treat patients with depression or various types of anxiety disorders.

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• Calcitonin G-related peptide (CGRP) antibodies:

  • These medications are newer options that block a circulating protein, called calcitonin G-related peptide. This peptide is known to initiate pain signals during a headache.​ These medications do not cause rebound headaches linked to medication overuse. It is most likely that this medication is made available to you by a headache specialist compared to a primary care provider. 

  • Rimegepant (Nurtec) or atogepant (Qulipta): This medication is used to stop current and prevent future headaches. When it's used to prevent future headaches, it's taken every other day. 

  • Eptinezumab (Vyepti): This is another possible treatment option to prevent headaches. This medication is administered intravenously (IV) every three months.