Migraines can be prevented by using certain medications, but very few actually use them, say the guidelines published by the American Academy of Neurology and the American Headache Society.

Seven prescription drugs and one herbal remedy have been listed as effective in preventing migraines in at least 38 percent of the estimated 35 million Americans who suffer from these debilitating headaches.

Each year migraines cost as much as $20 billion to the U.S treasury, both in terms of direct medical costs and loss of productivity- according to media reports.

“Studies show that migraine is under-recognized and under-treated,” said the guideline author Dr. Stephen D. Silberstein of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow at the American Academy of Neurology.

According to the guideline, the medications that are effective in preventing migraine attacks or reduce the severity of the attacks are: Anti-seizure drugs like divalproex sodium, sodium valproate and topiramate; Beta-blockers like metoprolol, propranonol and timolol; certain over-the-counter drugs like fenoprofen, ibrufen, ketoprofen, naproxen and naproxen sodium, subcutaneous histamine (nonsteroidal anti-inflammatory drugs); complementary treatments like magnesium, MIG-99 (feverfew) and riboflavin; herbal petasites and butterbur.

Although, these drugs are available over-the-counter, Dr. Silberstein warns that certain precautions must be taken while using these and he advised people to regularly visit their doctor for follow-up appointments.

“Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication. In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side-effects or interact with other medications, which should be monitored,” said , Dr. Silberstein.

Experts say that preventive medication will not help all those who suffer from migraines. It is advised to consult a specialist before taking any medicines to prevent or treat migraines.

"Some people have one migraine a month, take over-the-counter medication, and can return to their usual activities," says Dr. Richard B. Lipton, director of the Montefiore Headache Center in New York. "Others might have 10 headache days a month that are disabling on five or six days, and they almost certainly need prevention and effective treatments for when they do get a headache."

The guidelines will be announced at the American Academy of Neurology’s 64th annual meeting in New Orleans on 24 April 2012.

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