Preventive Treatment of Migraine


  • Conflict of Interest: No conflict.

R.E. Shapiro, Department of Neurology, University of Vermont College of Medicine, Arnold 2435B, University Health Center, 1 South Prospect Street, Burlington, VT 05401-3456, USA, email:


Migraine is a prevalent and disabling episodic brain state with protean symptoms dominated by headache. When migraine attacks are frequent or severe over a sustained period, use of daily preventive medications are indicated to significantly reduce disability and improve quality of life. Recently issued evidence-based guidelines outline an array of pharmaceutical and complementary treatment choices with data establishing them as effective or probably effective for prevention of episodic or menstrually associated migraine. OnabotulinutoxinA is the only Food and Drug Administration-approved medication for the prevention of chronic migraine.