Migraine Prevention: Daily Habits and Medicines That Mean Fewer Attacks

Written by Naurah Gaspard, DNP, FNP-C, FNP-BC · Medically reviewed by Cherlie Joseph, MSN, FNP-BC · Updated November 2026

If you have migraine on about 4 or more days a month, or attacks that disrupt your life, preventive treatment is worth discussing. Options range from steady sleep, meals and exercise to daily or monthly medicines, including older pills like propranolol and topiramate and newer CGRP medicines that the American Headache Society now considers a first-line choice.

When preventive treatment makes sense

Preventive treatment is worth discussing if any of these fit you:

• Migraine on about 4 or more days a month, especially if attacks disrupt work or home life
• Attacks that last a long time or do not respond well to acute medicine
• Needing acute medicine (pain relievers or triptans) on many days a month, which risks medication overuse headache
• Chronic migraine: headache on 15 or more days a month for more than 3 months, with migraine features on at least 8
• Prolonged or disabling aura

The goal is realistic: a good preventive often cuts migraine days by about half and makes the remaining attacks easier to treat. It rarely makes migraine disappear completely.

Daily habits that reduce attacks

Habits will not replace medicine for everyone, but they make any treatment work better. Headache specialists often use the acronym SEEDS:

Habit	What to aim for
Sleep	Same bedtime and wake time every day, 7 to 9 hours; screen for snoring or sleep apnea
Exercise	Regular aerobic activity, such as brisk walking 30 minutes most days; build up slowly
Eat	Regular meals, no long gaps, steady caffeine and plenty of water
Diary	Track headache days, triggers and medicine use to measure progress
Stress	Relaxation training, cognitive behavioral therapy, biofeedback, yoga or mindfulness

Some supplements, such as magnesium and riboflavin (vitamin B2), have modest evidence for migraine prevention. Check with your provider first, since supplements can interact with medicines or cause side effects. Our guide to migraine triggers explains how to set up a diary.

Preventive medicines compared

NINDS lists several groups of preventive medicines. In 2024 the American Headache Society stated that CGRP-targeting therapies can be used as a first-line option, without first trying and failing older pills.

Type	Examples	Good to know
Beta blockers	Propranolol, metoprolol, timolol	Inexpensive generics; can cause fatigue or dizziness; not ideal with asthma
Anti-seizure medicines	Topiramate, divalproex	Topiramate can cause tingling and word-finding trouble; divalproex is avoided in pregnancy
Antidepressants	Amitriptyline, venlafaxine	Helpful if sleep or mood is also an issue; can cause drowsiness or weight change
CGRP monoclonal antibodies	Erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality), eptinezumab (Vyepti)	Monthly or quarterly injection, or an IV infusion every 3 months for eptinezumab; generally well tolerated; constipation possible with erenumab
Gepants (CGRP pills)	Atogepant (Qulipta) daily; rimegepant (Nurtec ODT) every other day	Rimegepant also treats acute attacks; nausea and constipation possible
OnabotulinumtoxinA (Botox)	Injections every 12 weeks	For chronic migraine only; given by trained specialists

Older pills are often chosen first because they are cheap and can also help another condition, such as high blood pressure or poor sleep. CGRP medicines are migraine-specific and often better tolerated, but they are brand-name and usually need insurance prior authorization. Prices change, so check manufacturer savings programs and discount tools such as GoodRx for current costs.

How to tell if prevention is working

Most preventives need time. Pills are usually started at a low dose and increased slowly, and a fair trial is generally 2 to 3 months at a target dose. CGRP antibodies can show benefit within the first month, but your provider may suggest giving them about 3 months. Keep your diary going so you can compare migraine days before and after.

If you are planning pregnancy, tell your provider before starting, because several preventives, including divalproex, topiramate and the CGRP medicines, are avoided or have limited safety data in pregnancy.

Getting care

If you already take a preventive or acute migraine medicine that works, a refill review can keep you on track. If you are thinking about starting prevention or switching, that is best handled at a visit, where a provider will review your history and whether a medicine is appropriate. OurTopClinic does not prescribe controlled substances such as butalbital or opioids, which can worsen headache frequency over time.

Frequently asked questions

How many migraines a month is too many?

There is no single cutoff, but 4 or more migraine days a month, or any number of attacks that keep you from normal life, is a common reason to consider prevention. Fifteen or more headache days a month for over 3 months is chronic migraine.

Are CGRP medicines better than older migraine pills?

Not necessarily better for everyone, but they are designed specifically for migraine and are often easier to tolerate. Older pills cost less and may help other conditions. The right choice depends on your health history, other medicines, pregnancy plans and coverage.

Do I have to take migraine prevention forever?

Not always. Many people who do well for 6 to 12 months can talk with their provider about slowly tapering to see if the benefit holds.

Sources

• Charles AC, et al. Headache (2024): AHS consensus statement on CGRP-targeting therapies for migraine prevention
• NINDS: Migraine
• MedlinePlus: Sumatriptan (medication overuse guidance)

Keep reading

• Migraine triggers and how to find yours
• Sumatriptan (Imitrex) for migraine
• Metoprolol: what to know
• Hormonal migraine
• Browse all conditions and treatments A to Z

This article is for general education and is not a substitute for medical advice. Treatment, including any prescription, is decided by a licensed provider after reviewing your health history. OurTopClinic is not for emergencies; if you have a medical emergency, call 911. OurTopClinic serves adults located in Florida, New Mexico, Oregon and Washington. Learn more at ourtopclinic.com.