Which medication should be avoided for headache prophylaxis due to potential serious side effects?

Venlafaxine, an antidepressant that belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) class, can be associated with serious side effects that make it less suitable for headache prophylaxis, particularly in certain populations. While it may be effective for migraine prevention in some cases, it also carries a risk of significant adverse effects, such as hypertension, which can be particularly problematic in patients with a history of cardiovascular issues. Additionally, venlafaxine can lead to withdrawal symptoms if discontinued abruptly, which creates further complications in patients who may experience recurrent headaches.

Other medications listed may have side effects but are more commonly accepted and utilized for headache prevention due to their profile. For example, amitriptyline and topiramate are often prescribed specifically for preventing migraines and have established efficacy in such contexts, while ibuprofen is frequently used for acute headache treatment rather than prevention. These alternatives typically present a favorable benefit-to-risk ratio compared to venlafaxine when considering chronic use in patients needing prophylaxis for headaches.