As many as 30 percent of migraineurs also suffer from tension, drug-rebound and other headaches. A complete physical and tracking of headache patterns with a headache diary are essential to identifying triggers of the pain. Those who suffer from chronic severe and disabling migraines (more than two or three each month) may benefit from these preventive medications. Each has significant side-effects and should be used under a doctor's supervision. These include:

• NSAIDs: Regular use of low-dose aspirin may reduce the occurrence of migraine, according to one study. Prescription-strength doses have also been found to reduce the frequency of headaches. Long-term use can lead to serious gastrointestinal problems, including bleeding of the stomach lining.
• Beta Blockers: Usually prescribed for cardiovascular disease, these medications can also reduce the frequency and severity of severe migraine.
• Anticonvulsants: Valproate and related drugs, used to treat epilepsy and bipolar disease, have recently been approved for the prevention of migraines.
• Antidepressants: Tricyclic antidepressants (amitriptyline (Elavil, Endep) and protriptyline (Vivactil) and selective serotonin-reuptake inhibitors or SSRIs (Prozac, Zoloft and Paxil) reduced the number and severity of migraine attacks by half in up to half of the patients in one study. The tricyclics are particularly effective for people who suffer from combined migraine and tension headaches.
• Calcium Channel Blockers: Also typically prescribed for heart patients, calcium blockers have been shown in clinical studies to be effective in preventing migraine. They may work by blocking the release of neurotransmitters (chemicals in the brain that stimulate nerve cells) involved in causing pain.

It is believed that one migraine-triggering factor may be stimulation of the trigeminal nucleus by increased neck and jaw muscle activity, such as clenching or grinding the teeth. Very often this behavior is unknown or unrecognized by the individual and can occur both during the day and when asleep. Intraoral dental devices are available to help an individual who is prone to jaw clenching to control this behavior, thereby reducing the possibility of excessively stimulating or "overloading" the trigeminal nerve system. Dentists with appropriate training and an interest in treating migraine can examine headache patients and determine if they are candidates for an intraoral device to help reduce or eliminate painful stimulus from jaw muscles.

These devices are made in different configurations covering all or some of either the upper or lower teeth. There are different schools of thought regarding the design of the different appliances, but all are intended to reduce the amount of jaw muscle activity be decreasing or altering clenching and grinding of the teeth.

One particular device that has received attention recently by being approved by the FDA is called the NTI-tss (Nociceptive Trigeminal Inhibition - tension suppression system), which was developed and patented by a dentist. The NTI-tss is an oral device that covers the upper four front teeth. Since there is some evidence that this device can be effective for treating migraines when used in the right circumstances, the Food and Drug Administration approved the marketing of the NTI-tss for the prevention of migraine headaches. This FDA approval was based on some research that shows that intraoral appliances can reduce the incidence of migraine headaches. Standards for approving medical devices are generally less stringent than those for approving medications.