Timothy C. Hain, MD, Chicago IL.• Page last modified: March 7, 2021

We moved these references out of our main migraine page to make the main content easier to print.

Definitions. This the group that decides what symptoms are needed for someone to be categorized as "migraine".

Migraine causes:

Migraine accompaniments involving hypersensitivity

Migraine in children

Migraine and dizziness or vertigo or hearing symptoms



Migraine treatment (also see subcategories) -- as a general comment, almost nothing works all the time, and migraine is really a collection of symptoms, not a disease.

Anticonvulsants -- these are often effective

Oxcarbazepine (probably ineffective)
  • Jenson M et al. Efficacy of oxcarbazepine in migraine: a prospectice open label trial (abstract). Ann meeting of the Am. Headache Society, 2002, Jun 21-23, Abstract S-96
  • Krusz J-C. Oxcarbazepine is effective in chronic migraine prophylaxis (abstract). Cephalagia 2000;20(4):425. Abstract 394
  • Nett RB, Krusz JC. Oxcarbazepine prophylaxis for chronic migraine and tension-type headache (abstract). Cephalgia 2002:22(7); 608-PB.35

Topiramate (somewhat effective)

  • Ho, J. D., et al. (2013). "Topiramate use and the risk of glaucoma development: a population-based follow-up study." Am J Ophthalmol 155(2): 336-341 e331.
  • Hunt, S., et al. (2008). "Topiramate in pregnancy: preliminary experience from the UK Epilepsy and Pregnancy Register." Neurology 71(4): 272-276.
  • Slberstein SD, Dodick DW, Hinrtz D, et al. Randomized placebo-controlled trial of propranolol added to topiramate in chronic migraine. Neurology 2012, Feb 29,
  • Thompson, P. J., et al. (2000). "Effects of topiramate on cognitive function." J Neurol Neurosurg Psychiatry 69(5): 636-641.
  • Margulis, A. V., et al. (2012). "Use of topiramate in pregnancy and risk of oral clefts." Am J Obstet Gynecol 207(5): 405 e401-407.

Valproate (Depakote) and Lamotrigine (Lamicgal);

  • Bisdorf A. Treatment of migraine associated vertigo with Lamotrigine. An observational study. Bull Soc Sci Med, 2004, 103-108. Comment: an uncontrolled study of 19 individuals.
  • Christensen and others. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA 2013:209(16) 1696-1703
  • Cutrer FM, Limmoth V, Moskowitz MA. Possible mechanisms of valproate in migraine prophylaxis. Cephalgia 1997:17:93-10

Antidepressants (generally SSRI or SNRI) -- often effective

Tricyclics (amitriptyline, nortriptaline, clomipramine)

  • Couch, J. R. and G. Amitriptyline Versus Placebo Study (2011). "Amitriptyline in the prophylactic treatment of migraine and chronic daily headache." Headache 51(1): 33-51.
  • Langohr, H. D., W. D. Gerber, et al. (1985). "Clomipramine and metoprolol in migraine prophylaxis--a double-blind crossover study." Headache 25(2): 107-113.  COMMENT: This study suggested that clomipramine is not a good drug for migraine. Not only was it ineffective, but it had "severe" adverse reactions.
  • Noone, J. F. (1977). "Psychotropic drugs and migraine." J Int Med Res 5(1 Suppl): 66-71. COMMENT: Noone felt that colmipramine was effective for migraine in a pilot study.

Venlafaxine and other SNRI's (Duloxetine)

  • Adelman, L. C., J. U. Adelman, et al. (2000). "Venlafaxine extended release (XR) for the prophylaxis of migraine and tension-type headache: A retrospective study in a clinical setting." Headache 40(7): 572-80.
  • Bulut, S., M. S. Berilgen, et al. (2004). "Venlafaxine versus amitriptyline in the prophylactic treatment of migraine: randomized, double-blind, crossover study." Clin Neurol Neurosurg 107(1): 44-8.
  • Curone, M., et al. (2013). "Outcome of patients with chronic migraine with medication overuse and depression after duloxetine: influence of coexisting obsessive compulsive disorder." Neurol Sci 34 Suppl 1: S175-177.
  • Diamond, S., B. J. Pepper, et al. (1998). "Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports." Neurology 51(1): 274-6.
  • Nascimento, E. D. (1998). "[Prophylaxis of migraine: open study with venlafaxine in 42 patients]." Arq Neuropsiquiatr 56(4): 744-6.
  • Ozyalcin, S. N., G. K. Talu, et al. (2005). "The efficacy and safety of venlafaxine in the prophylaxis of migraine." Headache 45(2): 144-52.
  • Tarlaci, S. (2009). "Escitalopram and Venlafaxine for the Prophylaxis of Migraine Headache Without Mood Disorders." Clin Neuropharmacol. Epub: 2009/08/12
  • Taylor AP, Adelman JU, Freeman Mc. Efficacy of doluxetine as a migraine preventive medication: possible predictors of response in a retrospective chart review. Headache 2007; 47(8) 1200-3
  • Todder, D. and B. T. Baune (2007). "Recurrence of suicidal ideation due to treatment with antidepressants in anxiety disorder: a case report." J Med Case Reports 1: 166.
  • Young, W. B., et al. (2013). "Duloxetine prophylaxis for episodic migraine in persons without depression: a prospective study." Headache 53(9): 1430-1437.

Various agents probably not effective

  • Foster CA, Bafaloukos J. paroxetine in the treatment of chronic daily headache. Headache 1994:34(10):587-9
  • Langemark M, lesen J. Sulpiride and paroxetine in the treatment of chronic tension-type headache. An explanatory double-blind study. Headache 1994;31(1):20-4

beta blockers -- effective with side effects

Botox -- occasionally effective at great cost.

Calcium channel blockers (verapamil, flunarizine, nimodipine, gabapentin) -- in special situations

CGRP blockers

Dopamine blockers (haloperidol and relatives, flunarizine, quetiapine) -- in special situations

NMDA inhibitors (e.g. memantine) -- we are dubious that these work.

Simvastatin+vitamin D -- we are dubious that this works.

Triptans -- often effective

Rebound headache

Migraine and Meniere's disease

Migraine and psychiatric disease

White matter lesions in migraine

Risk of other serious neurological illness: