Table 3.

First-line preventive treatment for migraine

Drug		Strength and dosage schedule	Max dose per day	Side effects
Beta-blocker	Propranolol	20-120 mg bid	240 mg	Reduced energy, tiredness, postural symptoms Contraindicated in asthma
	Metoprolol	25-100 mg bid	200 mg
Anticonvulsant	Valproate	400-600 mg bid	1200 mg	Drowsiness, weight gain, tremor, hair fall, fetal abnormality, contraindicated in women of child bearing potential
	Topiramate	12.5-100 mg bid	200 mg	Paresthesia, weight loss, glaucoma, nephrolithiasis
Antidepressants	Amitriptyline	10-75 mg qd	75 mg	Drowsiness, dry mouth
	Nortriptyline	10-75 mg qd	75 mg
	Venlafaxine	75-150 mg qd	150 mg
Calcium channel blocker	Flunarizine	5-10 mg qd	10 mg	Drowsiness, weight gain, depression, parkinsonism