If you experience more than three significant migraine attack days per month, you should speak to your doctor about preventive medications.

There are a number of preventive medication options available for you to try that may help prevent your migraine attacks. Most of the medication options we have are old drugs that were designed to treat other conditions but have been found helpful for migraine. New medications that have been designed specifically for migraine are also available, but you may need to try some other medications first to access these new medications on the PBS. 

Older daily preventive medications: blood pressure, anti-depressant, and anti-epileptic medications

For a very long time the only options we had to help prevent migraine attacks were medications designed for other conditions. These can help and be well tolerated by some people to reduce the number and severity of migraine attacks. These include:

• Beta-blockers are blood pressure medications, the most commonly prescribed is Inderal.
• Anti-epileptic medications more commonly used in epilepsy, such as Topamax.
• Anti-depressants such as amitriptyline.

New preventative medications: CGRPs

CGRP therapies are a new type of medication used to prevent migraine attacks.

The medication blocks a protein called calcitonin gene-related peptide (CGRP) or its receptor. CGRP may cause inflammation and pain in the nervous system of people who live with migraine. Research identified CGRP as a chemical that surges in our systems during a migraine attack; and by blocking the CGRP we can block some of the migraine attacks. CGRP antagonist medications have been designed specifically for migraine. They may be very effective and have fewer side effects. However, they are expensive, and getting subsidised access to the medications on the PBS is limited.

See our detailed section on the CGRP medications

More intensive interventions

If these medications do not work, there are other things to try, including Botox. Note, as of 2024, CGRP therapies are considered first line treatment and should be tried before Botox.

Read more about Botox as a preventative treatment

Other interventions may include a Greater Occipital Nerve Block, Ketamine infusions, 

Factsheet: Preventive Medications for Migraine

• Information on preventative medications options
• Clinically reviewed by Dr Bronwyn Jenkins (BMed FRACP)

The Migraine Trust also has a particularly good page on preventative options.