The first results of preventive measures appear a few weeks or months after the start of treatment. Many patients notice an improvement in condition only when taking medicines in therapeutic doses for 3-4 weeks. To identify the rapid efficacy of the therapy, it is especially useful to compare the diaries of patients before and after treatment.
The initial effect of prophylactic treatment is often manifested in the form of a decrease in the duration or intensity of headaches, rather than the number of days in which headaches are completely absent.
For this reason, it is the diaries that record the intensity of headaches several times a day that are optimal for evaluating the preliminary results of preventive treatment. Patients who fill in diaries only once a day risk missing important signs that the treatment is starting to take effect.
In patients taking any prophylactic drugs, it is necessary to analyze both the efficacy and tolerability of the treatment. The most common side effects of drugs used for prophylactic purposes are sedative effects and effects on cognitive functions. Moreover, the Food and Drug Administration recently issued a warning about the increasing risk of suicides among patients taking some of the antiepileptic drugs, such as gabapentin, pregabalin, topiramate and valproate. Mood changes also occur in patients taking antihypertensive drugs from the group of b-blockers.