Effective, Affordable & Accessible Migraine Preventive Medications

Day 6 (2025)

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Key Questions

What obstacles do patients encounter in the U.S. when seeking effective migraine care, especially from specialists?
How can a patient request a referral to a headache specialist if their symptoms aren’t improving?
How can American patients who cannot access a headache specialist work with their primary care provider to manage migraine?
How can a patient convey the impact of migraine on their daily life to help their doctor understand the need for specialized care?
What types of medications and other treatments are available in the U.S. for preventing migraine attacks and headaches?
How do different classes of preventive migraine medications compare in terms of cost and effectiveness?
What over-the-counter medicines can help prevent or treat migraine attacks?
Are generic medications as effective as brand-name medications for migraine?
Why is it important to prevent and not just treat migraine attacks and headaches when possible?
Are there ways to reduce the costs of consultations and treatments for migraine and headache disorders?
What can patients do if they cannot afford the treatments prescribed by their doctor?
How can U.S. patients help improve access to and quality of care for those who experience migraine and headache disorders?

Interview Notes

Treatments Mentioned

- - Acetaminophen/Paracetamol
  - Amitriptyline
  - Angiotensin II receptor blockers (ARBs)
  - Atogepant (Qulipta)
  - Beta-blockers
  - Candesartan
  - CGRP small-molecule receptor antagonists (gepants)
  - CGRP monoclonal antibodies (mAbs)
  - Cefaly
  - Coenzyme Q10 (CoQ10)
  - Eptinezumab (Vyepti)
  - Erenumab (Aimovig)
  - Feverfew
  - Fremanezumab (Ajovy)
  - Galcanezumab (Emgality)
  - Ibuprofen (Advil)
  - Lasmiditan (Reyvow)
  - Lisinopril
  - Magnesium
  - Nerivio
  - Neuromodulation devices
  - OnabotulinumtoxinA (Botox)
  - Propranolol
  - Riboflavin (vitamin B2)
  - Rimegepant (Nurtec ODT)
  - Transcutaneous electrical nerve stimulation (TENS) device
  - Topiramate
  - Tricyclic antidepressants
  - Triptans
  - Ubrogepant (Ubrelvy)

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Expert

Fred Cohen, MD

Assistant Professor of Medicine and Neurology
Mount Sinai Headache and Facial Pain Center, Icahn School of Medicine

Dr. Fred Cohen is an assistant professor of medicine and neurology at the Icahn School of Medicine at Mount Sinai-New York City. Dr. Cohen received his medical degree from Stony Brook University School of Medicine. He completed a residency in internal medicine at the Montefiore Medical Center, Albert Einstein College of Medicine, followed by a fellowship in headache medicine at the Jefferson Headache Center, Thomas Jefferson University Hospital.

Dr. Cohen is one of the few headache specialists in the country trained in both internal medicine and headache medicine. His research has been published in several medical journals, including Headache, Cephalalgia, Pain Medicine, and Neurotherapeutics, and he serves on the editorial board for Headache: The Journal of Head and Face Pain.