Table 1.

Commonly used migraine prophylactic medications

Drug1	Initial dose (mg)	Typical total daily dose range (mg)	Common side-effects	Serious side-effects
Amitriptyline	10	25–150	Weight gain, constipation, sedation	Cardiac dysrhythmias
Nortriptyline	10	25–150	Weight gain, constipation, sedation	Cardiac dysrhythmias
Divalproex sodium	250–500	750–1500	Alopecia, weight gain, nausea, tremor	Pancreatitis, liver failure, thrombocytopenia
Propranolol	40–60	40–240	Depression, fatigue	Bradyarrhythmia
Atenolol	25	50–100	Depression, fatigue	Bradyarrhythmia
Verapamil	80–160	160–480	Edema, constipation	Hypotension, dysrhythmias
Gabapentin	300	900–2400	Edema, sedation, fatigue, dizziness
Topiramate	15–25	75–200	Paresthesias, fatigue, weight loss	Acute angle closure glaucoma, hyperthermia, metabolic acidosis, nephrolithiasis