Dr. Alexander Mauskop

Some women have menstrual and ovulation migraine that lasts for several days and acute treatments don't work.

For them, that would be appropriate to try preventive measures.

But there are people who have twice, three times a week, but they say, sumatritum is like magic.

I don't want to take preventive drugs because some preventive drugs, the old ones, epilepsy drugs and antidepressants can cause more side effects.

Okay, let's start with FDA-approved.

So we have about a dozen preventive treatments that are FDA-approved, starting with, I mentioned, beta blockers like propranolol and another one.

And then there are a couple of epilepsy drugs, Devalproxodium, Depakote, and Topiramate, Topamax.

And then we have Botox, and we have now G-Pens.

And we also have monoclonal antibodies, very advanced treatment for migraines that, again, addresses the CGRP chemical, calcitonin gene-related peptide.

Three of those are self-injected once a month for prevention.

And one of them infused intravenously every three months.

And they can be extremely effective.

About 50% of people have very good response to that.

So those are FDA approved.

And Botox is also FDA approved for chronic migraines.

Well, that's the second part of your question.

Most of them do, but they have certain prerequisites.

For example, you have to fail two old preventive drugs, like a blood pressure medication or antidepressant or epilepsy drug.

And most of them will cover eventually Botox.

That's a great question because, yes, I tell patients it's not a magical cure because they come in and tell me, Botox was great, but why did I get a headache?