Drugs used in the treament of migraine fall into three general classes: preventive or prophylactic medications abortive medications analgesics or pain-killers In order to work properly, prophylactic medications must be taken day in and day out, and not just during an attack of migraine. Migraine-specific abortive medications are given at the time of a migraine attack and are intended to end or abort the attack. Analgesics are given during an attack to lessen the pain. Factors that influence the selection of the proper medication regimen are very specific to the individual patient. Some of them are: frequency and severity of the migraines, other medical conditions present, sensitivity of the patient to certain medications, personal preferences of the patient, etc. Considerations in taking migraine medications: Take them according to the schedule prescribed by your doctor. The proper dosage schedule has often been determined by research studies. Failing to take the medication properly could mean that it won't work and a chance for successful treatment will be wasted. Tolerance and loss of effectiveness (tachyphylaxis) may be a problem. Often, after weeks or months, the body develops a tolerance for a medication and the dose has to be increased. But the dose can only be increased so far, because toxic effects will eventually occur. While some patients can remain on a medication and have it work well for them for years, others will have to switch to a new type of medication after a period of time. After a rest period of months, the original medicine can often be restarted and will work again. Pregnancy. Fortunately, many women have less migraine during pregnancy due to a more favorable hormonal situation. Those who don't are faced with either having to tough it out with the headaches or taking medication while pregnant. If analgesics such as acetaminophen (Tylenol) or even merperidine (Demerol) can suffice, then this is the preferred treatment. Some patients will have such frequent headaches that a prophylactic, such as a beta blocker, will be needed. Certain prophylactics, such as valproic acid (Depakote) are known to have a high incidence of birth defects, and so should not be used in pregnancy. NSAIDs also are not recommended. Drug interactions. Many patients go to more than one doctor. When you visit your doctor, always bring all of your medications with you so that the doctor can determine what you are taking and how much. Some medicines can interact in a dangerous way. Pharmacists are also a good source of information about drug interactions.