title: [Prophylactic medicines for migraine].
abstract: Migraine patients with frequent and disabling attacks should  be given the opportunity to test prophylactic medicines, and general practitioners  should know the indications and the main principles of treatment.  When testing a preventative drug, it is important that the patient  has realistic expectations, keeps a headache diary, increases the  doses gradually, and takes an adequate dose for at least two months  before the effect is assessed. Drugs licensed in Norway with adequate  scientific documentation for use as migraine prophylactics include  some antihypertensives (beta-blockers, candesartan and lisinopril),  antiepileptics (topiramate, valproate and gabapentin), an antidepressant (amitriptyline),  and botulinum toxin for chronic migraine. In the choice of medicine, one  should consider scientific evidence, side effects and contraindications,  effect on comorbid conditions, simplicity of use, and price. Patients  who are severely affected should try at least three different drugs  in succession.
authors.affiliation: Nasjonalt kompetansesenter for hodepine, Institutt for nevromedisin, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet. lars.stovner@ntnu.no
authors.forename: Lars Jacob
authors.initials: LJ
authors.lastname: Stovner
authors.forename: Erling
authors.initials: E
authors.lastname: Tronvik
authors.forename: Knut
authors.initials: K
authors.lastname: Hagen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000075202:Contraindications; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control; D010147:Pain Measurement
chemical_list: D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D000959:Antihypertensive Agents