From the Guidelines
Phentermine is not recommended for migraine prevention. This medication is primarily approved for short-term weight loss treatment and works as an appetite suppressant by stimulating the central nervous system. There is no established evidence supporting phentermine's effectiveness for preventing migraines, as noted in the studies reviewed 1.
Instead, if you're seeking migraine prevention, consider FDA-approved preventive medications such as:
- Topiramate (starting at 25mg daily, gradually increasing to 50-100mg twice daily)
- Propranolol (40-160mg daily)
- Amitriptyline (10-150mg at bedtime)
- Newer CGRP antagonists like erenumab (Aimovig, 70-140mg monthly injection)
These medications work through different mechanisms that specifically target migraine pathways, such as calming overactive brain cells, regulating blood vessels, or blocking pain signals. Phentermine may actually worsen migraines in some people due to its stimulant properties that can increase blood pressure and heart rate. Always consult with a healthcare provider who specializes in headache medicine to determine the most appropriate preventive treatment based on your specific situation, medical history, and migraine pattern.
From the Research
Migraine Prevention Treatments
- The following medications are recommended as first-line agents for migraine prevention: propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate 2
- Gabapentin and naproxen sodium have fair evidence of effectiveness for migraine prevention 2
- Botulinum toxin has demonstrated fair effectiveness, but further studies are needed to define its role in migraine prevention 2
- Anti-epileptic drugs, such as topiramate and valproate, are effective for the preventive treatment of migraine 3
- NSAIDs, beta-blockers, calcium channel blockers, antidepressants, and antiepileptics are options for migraine treatment and prophylaxis 4
Phentermine for Migraine Prevention
- There is no mention of phentermine as a treatment option for migraine prevention in the provided studies 2, 3, 5, 4, 6
- The studies discuss various medications and treatments for migraine prevention, but phentermine is not included as a recommended or studied treatment option
Alternative Treatment Options
- Non-pharmacological treatments, such as relaxation techniques, bio-feedback, cognitive behavioral therapy, and acupuncture, are supported by some evidence but require more specialist time or technical devices 5
- Neuromodulation devices, including external trigeminal nerve stimulation and single-pulse transcranial magnetic stimulation devices, have modest evidence to support preventive use 6