Abstract

Migraine is a common and disabling recurrent headache disorder. Its burden on individual's quality of life makes migraine to be a serious health problem. Preventive pharmacological treatment is one of major categories in migraine treatment along with acute and nonpharmacologic managements. Preventive treatment is required in those with fre- quent or disabling attacks of migraine to minimize the disability, to prevent medication overuse, and to improve the quality of life. Beta blockers, of which propranolol is the representative, are the most reliable preventive drugs of proven efficacy. Amitriptyline is also a reliable migraine preventive drug in antidepressants in spite of newer drugs such as SSRI or SNRI came to practice. Neuromodulators including valproic acid and topiramate are expected to be used more in the future based on their mechanism of action. All practitioners also should keep in mind several points considered in preventive managements, such as efficacy of drugs, comorbidities and duration of prophylaxis.