Prophylactic therapy for patients with frequent, severe migraines

    These new guidelines recommend prophylactic therapy for patients with frequent, severe migraines...usually 3 or more migraines a month that are hard to treat.

    Several beta blockers are effective. Try atenolol... metoprolol...nadolol...or propranolol.

    Two calcium blockers, verapamil and flunarizine (Sibelium), work as well as the beta blockers...but they have a slower onset. Tell patients it may take several months to see an improvement.

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