Know What to Expect. . . And What's Expected of You

Unrealistic expectations and unexpected negative reactions to medications are the major sources of patient dissatisfaction with migraine prevention. Remember, even the most effective preventive agents are only about 50 percent better than using nothing at all. And fewer than 10 percent of patients become completely headache-free with preventive therapies. Chances are, you'll still need to use medications for those attacks that "break through" your preventive defenses.

It is very important that you take your preventive medication exactly the way your healthcare provider instructs. If you don't, it will almost certainly affect the success of your treatment. It may even cause problems. So if you don't notice a difference after only one or two weeks of therapy, don't give up. Taking a preventive medication for too short a time is a key cause of treatment failure. Likewise, you may notice improvement after just seven to ten days, but a migraine prevention drug should be used for at least two or three months to truly evaluate its effectiveness. Finally, although it seems like common sense, if your migraine attacks are well controlled at relatively low dosages, you should avoid additional dosage increases.

Remember to keep a headache diary before and after initiating preventive therapy, recording headache frequency, duration, and severity along with other factors. This diary will aid your healthcare provider in assessing the efficacy of a preventive regimen.

Click here to see a sample of a headache diary.