Table 4.

Preventive therapies for migraine*

Group 1Group 2Group 3§Group 4Group 5
* Does not include combination products.
† Medium to high efficacy, good strength of evidence, and mild-to-moderate side effects.
‡ Lower efficacy than those listed in first column, or limited strength of evidence, and mild-to-moderate side effects.
§ Clinically efficacious based on consensus and clinical experience, but no scientific evidence of efficacy.
¶ Medium to high efficacy, good strength of evidence, but with side effect concerns.
∥ Evidence indicating no efficacy over placebo.
AmitriptylineB-blockersA: AntidepressantsMethysergideAcebutolol
Divalproex sodiumAtenolol/metoprolol/nadololDoxepineCarbamazepine
Propranolol/timololFluvoxamineClomipramine, clonazepam
Ca-blockersImipramineClonidine
Nimodipine/verapamilMirtazepineIndomethacin
NortriptylineNicardipine
NSAIDsParoxetineNifedipine
Aspirin/fenoprofen/flurbiprofenProtriptylinePindolol
KetoprofenSertraline trazodone
Mefenamic acidVenlafaxine
NeproxenCyproheptadine diltiazem
Naproxen sodiumIbuprofen
Fluoxetine (racemic)Tiagabine
GabapentineTopiramate
OtherB: (side effect concerns)
FeverfewMethylergonovine (methylergometrine)
Magnesium vitamin B2Phenelzine