Table 2.

Prophylaxis for Migraines

Class	Formulation	Relative Contraindications	Reduction in Migraine Attacks per Month vs Placebo	Other
Beta blockers	PO	Asthma Depression CHF Raynaud’s disease Diabetes Bradycardia	1.26³⁷
Calcium channel blockers	PO	Constipation Hypotension Sick sinus syndrome Second- or third-degree AV block without pacemaker Severe left ventricular dysfunction		May be combined with NSAIDs
Ace inhibitors	PO	Pregnancy Hereditary or idiopathic angioedema	1.5³⁸
Antiepileptics	PO	Pregnancy Kidney stones Bleeding disorders Weight loss concerns	2³⁹	Sedative and confusion
Tricyclic antidepressants	PO		6.9⁴⁶
Anti-CGRP antibody	IV	Avoid in pregnancy and in adults with cardiovascular risks or vascular malformations	N/A