Your doctor probably won't suggest prophylactic treatment unless you have several attacks per month. If you take drugs this way your physician will monitor you for side effects, such as weight gain, water retention, lethargy, memory impairment, and hallucinations. Do not try to combine any weight loss medications with prophylactic drugs, and do not stop taking the drugs suddenly. Here are a few principles of prophylactic treatment:
• It should begin with low doses, which are increased slowly.
• Every month or two, it should be tested to see if it is working correctly.
• Your doctor should check that you are not taking any other drugs or vitamins that could interfere with the headache medication.
• You should be sure you are not pregnant. Medication should be tapered off and discontinued once your headaches are under control.
Although there is no set schedule for how long someone should stay on prophylactic therapy, many experts consider more than six months excessive.
The major prescription drugs used to treat tension, migraine, and sometimes cluster headaches prophylactically include: beta blockers such as Tenormin, Lopressor, and Inderal; calcium channel blockers such as Cardizem, Dilacor, and Procardia; antidepressants such as Elavil and Zoloft; serotonin antagonists such as Sansert; anticonvulsants such as Tegretol, Depakote, and Dilantin; and ergot derivatives such as Cafergot and Sansert.
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