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What medication is most effective for preventing migraines?

This is not really answerable as different medications are effective in different people. The most commonly used ones are amitriptyline, propranolol, topiramate, and divalproex. Others are occasionally effective, but that list is very long. 

The most important consideration is that the medications are tolerated and taken for long enough at a sufficient dose before determining whether it is effective.

Steven A. Meyers, MD
Diagnostic Radiology
The most effective migraine preventative is the one that works best for the individual. Old medications may work better than new ones. The newest treatment that has been approved by the Food and Drug Administration for migraine is Botox injections, which are only approved for patients with more than 15 days of migraines each month.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.