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Headache Medications: Pros and Cons

Headache medications include several classes of drugs that are effective. Most of them are quite effective as migraine headache treatments to prevent migraines.

Most of the time, these drugs can be taken at doses MUCH LOWER than doses used for other problems. Unfortunately, some people are frightened of headache medications and will refuse to even try them, believing they will get every side effect listed.

Let's review the most commonly used prescription drugs from a sensible point of view, OK?

  • Anti-Seizure Medications

This is probably the most effective class of drugs for lowering frequency and pain level of headaches. I have used the drugs I discuss on thousands (!) of patients and am pretty familiar with how the patients respond.

These drugs are appropriate for you if:

1. You have 1 or 2 severe, disabling headaches per month and/or..

2. You have 2 to 3 headaches per week.

The most effective drugs for headache are as follows:


  • Anti-Depressants
Now don't freak out! This class of drugs is very effective not only to treat mood but also to alieviate pain.

Almost 85% of all chronic pain patients have depression and/or anxiety to some degree.

Chronic illness such as fibromyalgia, MS, diabetes, and headaches can all lead to depression if the condition is more than six months old. More about the impact of depression on headaches.

  • Botox

Botox for migraine is an exciting newer option for you if you have migraines that have failed to respond to the above options.Discuss this with your doctor and find a clinician skilled in doing Botox.

  • Opiods
This includes drugs such as hydrocodone, Lortabs, Tylenol with Codeine, Fiorcet and Ultram for headache.

Many times these medications are handed out by well meaning health care professionals to try and treat a patient in acute pain of headache. Unfortunately, too many times patients become addicted to these drugs as the headaches become worse and worse.

Using these types of headache medications more than three times per week for headaches can actually make the headache syndrome WORSE!


  • Anti-Psychotics
Once again don't freak out! These medications are not first line in treating constant chronic daily headache, but they are effective when nothing else has worked. They tend to dampen the pain pathways in the brain and reduce the frequency and pain level of the headaches.

The most promising in the class currently for headaches are Seroquel and Zyprexa and once again I use very low doses.


  • Beta-Blockers
Beta-blockers such as Inderal(propranalol) were also one of the earlier drugs found to be effective in preventing migraine. Unfortunately, it is not as effective as anti-seizure medications, but that does not mean it might not work for you.

For severe migraines during pregancy, beta-blockers in very low doses can be effective. The important thing to remember when pregnant and considering a drug, is that severe pain, nausea and vomiting is not good for you or the baby.

Pain raises adrenaline levels, causing an increase in blood pressure and repetative vomiting causes dehydration. It is best to treat the headaches and keep you and your baby healthy.

  • Calcium Channel Blockers
This is another class of anti-hypertensives like beta-blockers that may help treat migraine. This drug in particular is effective if you have a lot of vertigo or spinning feelings with your headaches.

The most commonly used drug for headaches is verapamil and is not used in higher doses for migraine as it is for cluster headaches.

Like the beta-blockers, this drug has the potential to lower your blood pressure and in addition may cause constipation.

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