Table 3.

Preventive therapies for migraine

TherapiesQuality of evidence*Scientific effect*Clinical impression of effect*Adverse effectsGroup
* See Appendix 2 for explanations of quality of evidence, scientific effect, and clinical impression of effect.
† Scale 1–5; see text for definitions.
? = not known; NSAIDs = nonsteroidal anti-inflammatory drugs.
Antiepileptics
CarbamazepineB++0Occasional to frequent5
Divalproex sodium/sodium valproateA++++++Occasional to frequent1
GabapentinB++++Occasional to frequent2
TopiramateC?++Occasional to frequent3a
Antidepressants
Tricyclic antidepressants
AmitriptylineA++++++Frequent1
NortriptylineC?+++Frequent3a
ProtriptylineC?++Frequent3a
Doxepin, imipramineC?+Frequent3a
Selective serotonin reuptake inhibitors
FluoxetineB++Occasional2
Fluvoxamine, paroxetine, sertralineC?+Occasional3a
Monoamine oxidase inhibitors
PhenelzineC?+++Frequent3b
Other antidepressants
Bupropion, mirtazepine, trazodone, venlafaxineC?+Occasional3a
Beta-blockers
AtenololB++++Infrequent to occasional2
MetoprololB+++++Infrequent to occasional2
NadololB++++Infrequent to occasional2
PropranololA+++++Infrequent to occasional1
TimololA++++Infrequent to occasional1
Calcium channel blockers
DiltiazemC?0Infrequent to occasional3a
NimodipineB+++Infrequent to occasional2
VerapamilB+++Infrequent to occasional2
NSAIDs
AspirinB++Infrequent2
Fenoprofen
Flurbiprofen
Mefenamic acid
IbuprofenC?+Infrequent3a
KetoprofenB++Infrequent2
Naproxen/naproxen sodiumB++Infrequent2
Serotonin antagonists
CyproheptadineC?+Frequent3a
MethysergideA++++++Frequent4
Other
FeverfewB+++Infrequent2
MagnesiumB++Infrequent2
Vitamin B2B+++++Infrequent2