While science hasn't discovered a cure for migraine headaches, breakthroughs in preventive therapy allow many patients to significantly reduce, or even eliminate their migraine headaches. But what are preventive medications, and how exactly do they work? Preventive medications, usually taken on a daily basis, can reduce or even eliminate most migraine attacks. Attacks which occur while on preventive medications are usually milder and easier to treat. There are a number of different kinds of preventive therapy, each of which works in a slightly different way. Most preventive medicines work by inhibiting the brain hyperexcitability that is commonly believed to be the source of migraine aura and headache. Beta-blockers are commonly prescribed for patients with high blood pressure or chest pain and also are effective at reducing brain excitability. Some antidepressants are also effective treatments for migraine. For example, Elavil works to increase brain serotonin and norepinephrine. Many of the drugs used to treat epilepsy are effective in migraine treatment. Two of these drugs, Depakote and Topamax, are approved by the FDA. In clinical trials, almost half of the Depakote patients and more than half of Topmax patients saw at least a 50% reduction in their migraine headaches. In addition, Topamax is associated with weight loss. While these drugs all work by directly affecting brain excitability, they do it in different ways. Some therapies work by regulating the serotonin levels in the brain. For example, antidepressants like Prozac, Zoloft, and Paxil regulate serotonin that might trigger a migraine attack. Topamax, which is the most prescribed brand for migraine prevention in the United States, works in a significantly different manner than all of the other therapies. Nerve cells in the brain communicate with chemical messengers called neurotransmitters When these nerve cells get excited, they may release too much of their transmitters. Some researchers believe that this triggers a migraine cascade. Topamax keeps many different excitable nerve cells in the brain calm, which lowers the chance of a migraine cascade starting. This can help to significantly reduce the number of migraine attacks that you get. Preventative therapy is the most effective ways to treat people who suffer from frequent migraine or even tension headaches. Although this type of therapy isn't a cure, it can reduce the number of headaches that a patient gets by more than 50%, sometimes eliminating them altogether. If you think you are suffering from migraine headaches and could benefit from one or more of these treatment options, please see a doctor with an interest in migraine today. The movies in this series can be viewed in any order. The videos which preceded this one discuss the cause of headache, migraine auras, identifying and avoiding headache triggers, and abortive therapies. If you'd like to learn more about these topics, please view the appropriate movie.