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Heading off migraines.

Is there any help for persistent migraines? Life is not worth living with them.

Arlene Gallman, Sun City, Arizona

Don't give up! Evidence-based treatment guidelines released in April by the American Academy of Neurology and the American Headache Society strongly endorse seven prescription beta-blockers and seizure drugs [see below] and one herbal preparation (butterbur) for preventing migraines and lessening symptoms when they do occur. And even Botox, better known for erasing age lines, got the thumbs-up in 2010.

Research also shows that managing common triggers (such as foods, stress, and bright lights), eating well, and getting enough sleep help prevent migraine pain. "But when the steps you can take without going to a doctor don't work, prescription medicines are well worth exploring," says Stephen D. Silberstein, M.D., of Jefferson Headache Center in Philadelphia and a Fellow of the American Academy of Neurology.

The point is to do something: Migraine is often undertreated, says Dr. Silberstein. It is estimated that only about one-third of migraine sufferers who could benefit from preventive treatments currently use them.

Review all the guidelines at neurology.org/content/78/17/1337.

Proof Positive

Prevent migraines with regular doses of these Rx drugs:

SEIZURE MEDICINES

Divalproex sodium (Depakote), sodium valproate (Depacon), and topiramate (Topamax). Frovatriptan (Frova) prevents menstrual migraine.

BETA-BLOCKERS

Metoproioi (Lopressor, Toprol), propranolol (Inderal), and timolol (Blocadren).

BY Cory SerVaas, M.D. and Wendy Braun, R.N.

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Title Annotation:Medical Mailbox
Publication:Saturday Evening Post
Article Type:Brief article
Geographic Code:1USA
Date:Sep 1, 2012
Words:232
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