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Medications effective for chronic migraine prevention
The evidence for efficacy of preventive medication is different for chronic migraine than for episodic migraine
Preventive Medications for Chronic Migraine with Target Doses or Dose Ranges
| Randomized Controlled Trials |
| OnabotulinumtoxinA 155 units (FDA approved) Topiramate 100-200 mg daily Divalproex sodium 500 mg bid Gabapentin 800 mg tid Tizanidine 8 mg tid Amitriptyline 100 mg daily Fluoxetine 40 mg daily Candesartan 16 mg daily Propranolol 160 mg long acting daily |
| Open Label |
| Pregabalin 150 mg bid Zonisamide 100-400 mg daily Atenolol 50 mg daily Olanzapine 2.5-35 mg daily Methylergonovine maleate 0.2-0.4 mg tid Memantine 10-20 mg daily in divided doses Combined? Anecdotal Venlafaxine 150 mg extended release daily |
Sources
From Evans RW: An update on the management of chronic migraine. Pract Neurol November/December, 27-32, 2013
