DRUG | DOSE | SELECTED SIDE EFFECTS |
---|---|---|
Beta blocker | ||
Propranolol | 40-120 mg bid | Reduced energy |
Metoprolol | 25-100 mg bid | Tiredness |
Postural symptoms | ||
Contraindicated in asthma | ||
Antidepressants | ||
Amitriptyline | 10-75 mg at night | Drowsiness |
Dosulepin | 25-75 mg at night | |
Nortriptyline | 25-75 mg at night | Note: Some pts may only need a total dose of 10 mg, although generally 1-1.5 mg/kg body weight is required |
Venlafaxine | 75-150 mg/d | |
Anticonvulsants | ||
Topiramate | 25-200 mg/d | Paresthesias |
Cognitive symptoms | ||
Weight loss | ||
Glaucoma | ||
Caution with nephrolithiasis | ||
Valproate | 400-600 mg bid | Drowsiness |
Weight gain | ||
Tremor | ||
Hair loss | ||
Fetal abnormalities | ||
Hematologic or liver abnormalities | ||
Calcitonin gene-related peptide (CGRP) monoclonal antibodies | ||
Erenumab-aooe | 140 mg monthly SQ injection | Injection site reactions |
Fremanezumab | 675 mg quarterly SQ injection or 225 mg monthly SQ injection | Injection site reactions |
Serotonergic drugs | ||
Pizotifenb | 0.5-2 mg qd | Weight gain |
Drowsiness | ||
Other classes | ||
Flunarizineb | 5-15 mg qd | Drowsiness |
Weight gain | ||
Depression | ||
Parkinsonism | ||
Candesartan | 4-24 mg daily | Dizziness |
Single pulse transcranial magnetic stimulation (sTMS) | 4-24 pulses per day | Lightheadedness Tingling Tinnitus |
Chronic migraine | ||
Onabotulinum toxin type A | 155 U | Loss of brow furrow |
No convincing evidence from controlled trials | ||
Verapamil | ||
Controlled trials demonstrate no effect | ||
Nimodipine | ||
Clonidine | ||
Selective serotonin reuptake inhibitors: fluoxetine |