Chapter 015. Headache (Part 12)

Table 15-7 Preventive Treatments in MigraineaDrugDoseSelected Side EffectsPizotifenb mg qd0.5–2Weight gainDrowsinessBeta blockerPropranolol40–120 mg bidReduced energyTirednessPostural symptomsContraindicated in asthmaTricyclicsAmitriptyline10–75 mg at nightDrowsinessDothiepin25–75 mg at nightNortriptyline25–75 mg at nightNote: Some patients may only need a total dose of 10 mg, although generally 1–1.5 mg/kg body weight is requiredAnticonvulsantsTopiramate mg/d25–200ParesthesiasCognitive symptomsWeight lossGlaucomaCaution with nephrolithiasisValproate400– 600 mg bidDrowsinessWeight gainTremorHair lossFetal abnormalitiesHematologic or liver abnormalitiesGabapentin900– 3600 mg qdDizzinessSedationSerotonergic drugsMethysergide qd1–4 mgDrowsinessLeg crampsHair loss ...
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Chapter 015. Headache (Part 12) Chapter 015. Headache (Part 12)Table 15-7 Preventive Treatments in MigraineaDrug Dose Selected Side EffectsPizotifenb 0.5–2 Weight gain mg qd DrowsinessBeta blocker Propranolol 40–120 Reduced energy mg bid Tiredness Postural symptoms Contraindicated in asthmaTricyclics Amitriptyline 10–75 Drowsiness mg at night Dothiepin 25–75 mg at night Nortriptyline 25–75 Note: Some patients may only need mg at night a total dose of 10 mg, although generally 1–1.5 mg/kg body weight is requiredAnticonvulsants Topiramate 25–200 Paresthesias mg/d Cognitive symptoms Weight loss Glaucoma Caution with nephrolithiasis Valproate 400– Drowsiness 600 mg bid Weight gain Tremor Hair loss Fetal abnormalities Hematologic or liver abnormalities Gabapentin 900– Dizziness 3600 mg qd Sedation Serotonergicdrugs Methysergide 1–4 mg Drowsiness qd Leg cramps Hair loss Retroperitoneal fibrosis (1-month drug holiday is required every 6 months) Flunarizineb 5–15 Drowsiness mg qd Weight gain Depression ParkinsonismNo convincing evidence from controlled trials VerapamilControlled trials demonstrate no effect NimodipineClonidineSSRIs: fluoxetine