Migraine Prophylaxis

Preventive medications work behind the scenes to lower your brain's tendency to trigger a migraine, rather than treating a headache once it has already begun. Dr. Golian may consider options such as topiramate, a beta-blocker, or another well-studied preventive agent, choosing based on your headache pattern, other health conditions, and how you respond.

These medicines are typically started at a low dose and increased gradually to find the gentlest effective level. Because prevention builds slowly, it often takes several weeks to feel the full benefit, and we track your progress together to fine-tune the plan.

The most helpful thing you can bring is a simple headache diary noting how often migraines occur, how long they last, and anything that seems to trigger them, such as sleep changes, stress, or certain foods. This helps us tailor the right preventive strategy for you.

Please share a full list of your current medications and supplements so we can complete a careful medication review and avoid interactions. Let us know about other conditions like high blood pressure, anxiety, or pregnancy plans, since these can guide which preventive medication is the safest fit.

We follow up regularly during the first few months to review your headache diary, check how you are tolerating the medication, and adjust the dose as needed. Most preventive plans are given a fair trial of two to three months before we judge how well they are working.

If your migraines remain frequent or severe despite an adequate trial, Dr. Golian can arrange a neurology referral and coordinate care with specialists including Cedars-Sinai in Los Angeles. The goal is steady, lasting relief, and we will keep refining your plan until you feel meaningfully better.