US Pharm. 2013;38(5):42.

Minneapolis, MN—A recent review concluded that although drugs routinely prescribed to prevent episodic migraines differ little in efficacy, they vary widely in terms of side effects. The studies included in the review involved mainly middle-aged women who had an average of five migraine attacks per month. All of the study drugs prevented at least 50% of migraines in 200 to 400 patients per 1,000 treated and were more effective than placebo. Off-label antidepressants and antiepileptics caused the worst side effects, with the medication usually being discontinued. Off-label angiotensin inhibitors and beta-blockers caused the fewest side effects. Besides the increased occurrence of immediate side effects, antiepileptics also can cause sexual problems with long-term use, a circumstance that would affect adherence.

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