Migraine Preventive Medication: What to Log Over Months
Migraine prevention diary for a prescribed preventive: what to log before and after the start, how reminders work and what sources say about timing.
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This is about a prescribed preventive, a medicine you take on a schedule, and not about avoiding triggers. At your next review your doctor will ask how the last months went, and memory is a poor record. You can keep a diary on paper or in Sam, where the preventive sits in your medication list with a reminder. This post covers what to write down, what sources say about timing and what to bring to the appointment.
When is a migraine preventive considered?
That is for your doctor to decide, not this post. According to the German AWMF guideline, the indication for a preventive medicine arises from a high burden of suffering, a reduced quality of life and the risk of medication overuse.
Acute medication, with one line per intake, has its own post: the migraine medication diary. This one is about the medicine you take regularly to prevent attacks.
Why start the diary before the preventive does?
Because a before-and-after comparison needs a before. The German guideline describes the success of a preventive as a fall in the number of migraine attacks and recommends a headache calendar for it. The German, Austrian and Swiss headache societies state in their consensus statement on treatment duration that reliable documentation of migraine frequency, headache days and the need for acute medication is required in every case.
The Migraine Trust diary has a line for preventive and regular medication and a field for changes. If you already keep a diary, carry on with the same tool when the preventive starts, so the months before and after look alike.
What do you log while you take a preventive?
No source gives a fixed field list for preventives. Put together from the German headache society's calendar, the Migraine Trust diary and the consensus statement, a useful list is:
- The start date and the name of the medicine as prescribed. The German calendar has a line for it at the top.
- Every change with its date, whether a new strength, a different interval, a switch or a pause, exactly as your clinic told you. More in medication dose change log.
- The intake itself: a tick per day for a daily medicine, the date of each dose for one taken every few weeks or months.
- Your migraine days and, separately, the days you took acute medication.
- A note in your own words, such as what you noticed since the start. Side effects are something to discuss with your clinic.
In Sam you add the preventive to your medication list, as a daily medicine or repeating every 1 to 12 weeks or months. A program is its own diary with a doctor report and a monthly questionnaire. The medication list belongs to you and works without one. When you start the migraine program, you pick the preventive you already take or add it there. You enter acute medication in the attack entry.
How long before anyone can judge it?
The sources give different spans, and none of them is a promise for you:
- The German headache society's online leaflet says effectiveness can be estimated no earlier than four to six weeks.
- IQWiG says it can take up to two months after the target dose is reached before attacks become less frequent.
- The Migraine Trust says it can take up to eight weeks to see any impact, and names at least three months to assess whether a preventive has helped.
- The American Migraine Foundation says two to three months after reaching the effective dose.
They also differ on when treatment is reviewed: the German guideline's flow chart names 6 to 12 months of treatment followed by a check, and its text a review at the latest after 24 months. The consensus statement says the optimal duration is not known. Your clinic decides who judges and when.
How do you remember to take it?
A daily medicine in Sam is part of the daily reminders: one notification per dose time, listing everything due then. It shows no dose. For more on phone reminders, see pill reminder on iPhone.
A medicine repeating every few weeks or months gets its own reminder on the due day, at a time you choose. Sam works out the next day from the dose you last logged. Tapping the reminder opens Sam, where you enter the day you had it, or that it was skipped.
Sam reminds and records. It gives no advice on dose, timing or catching up. If you have forgotten a dose, the leaflet says what applies, and your pharmacist or doctor can answer it for you.
What do you note when a dose changes or you switch?
The date and what changed, as your clinic told you. Whether to change anything is a question for your clinic, not a diary. In Sam, the earlier version stays on record when a dose changes. If a medicine ends, you enter a stop date.
What do you bring to the review appointment?
- The migraine days of the months before the start and since, side by side.
- The start date and every change with its date.
- The intake record, including skipped doses.
- The days with acute medication.
- Your notes and questions.
The migraine program's doctor report covers part of this, as a PDF for the period you pick. For a daily preventive it lists the medicine with its plan and "Doses taken as scheduled" with a percentage and counts, along with adjusted, skipped, unlogged and extra doses. For a medicine taken every few weeks or months it has a "Regular treatments" block with the dates given, days between doses, skipped dates and the last dose, with no percentage. Migraine days appear as one total for the period, and only days with acute medication are shown per month. The report has no side-by-side comparison. The report shows what you entered. What it means for your treatment is for you and your clinic to go through. More on preparing in medication list for your doctor.
Log your preventive in Sam and take it to your appointment
You log what you take and bring the course of it, not a recollection.
- Instead of a slip of paper or a notes app: the preventive sits in your medication list, daily or repeating every few weeks or months, with a reminder.
- Instead of estimating at the appointment: the doctor report in the migraine program, alongside your attack diary, shows your preventive entries and your days with acute medication as a PDF.
- Instead of remembering the due day: a daily medicine is in the daily reminders, and one that repeats every few weeks or months gets a reminder on the due day.
- More on the list under medication in Sam.
Sam records and reminds and gives no advice on dose or intake.
Try Sam HealthSam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.
Related reading
- Migraine medication diary: what to record each time
- Migraine diagnosis: what now? Your first weeks
- Medication dose change log: what to write down
Sources
Updated: October 2026
- AWMF: S1 guideline 030/057, Therapie der Migraeneattacke und Prophylaxe der Migraene (DGN, DMKG), version 7.1, August 2025, valid until August 2028, in German
- DMKG: Patient information on migraine (online leaflet, undated, in German)
- DMKG: Headache calendar (PDF, in German)
- German, Austrian and Swiss headache societies (DMKG, OEKSG, SKG): Consensus statement on the duration of pharmacological migraine prophylaxis, Der Schmerz 2023 (online 2022), in German
- IQWiG, gesundheitsinformation.de: Preventing migraine in adults, updated 13 July 2022, in German
- The Migraine Trust: Preventive medicines, last reviewed January 2025 and headache diary (PDF)
- American Migraine Foundation: Preventive Treatments for Migraine, September 2026
More on Migraine
Frequently Asked Questions
What should I log while I am on a migraine preventive?+
The date it started, its name as prescribed, every change with a date, the intake itself, your migraine days and the days you took acute medication. The German headache society's calendar has a line for the preventive, and the Migraine Trust diary has a line for preventive and regular medication and a field for changes. Ask your clinic whether it wants anything else.
How long should I keep a diary while on a preventive?+
Your clinic decides. The German guideline lists a headache diary as monitoring in its flow chart for preventive treatment, and the Migraine Trust says keeping one while you take your medicines can help your doctor monitor whether it is helping. The sources give very different time spans, so an unbroken calendar over several months is the simplest basis for a conversation.
How long before my doctor can tell whether it is working?+
Sources differ. The German headache society's online leaflet says no earlier than four to six weeks. IQWiG says up to two months after the target dose is reached. The Migraine Trust says up to eight weeks and at least three months to assess it. The American Migraine Foundation says two to three months after reaching the effective dose. Who judges it, and when, is your doctor's call.
Why does my doctor ask for my migraine days before I start?+
The German guideline describes the success of a preventive as a fall in the number of migraine attacks. Without a record from before, there is nothing to compare with. Your clinic names the numbers it cares about.
Is there a reminder for a migraine preventive in Sam?+
Yes, through the medication list. A daily medicine is part of the daily reminders. One that repeats every 1 to 12 weeks or months gets its own reminder on the due day. Sam reminds and records and gives no advice on dose or intake.
What should I do if I forget a dose?+
Sam does not answer that. The package leaflet, your pharmacist or your doctor tells you what applies to your medicine. In Sam you can record that a dose was skipped.
Are the preventive and acute medication logged in the same place?+
In Sam the preventive lives in your medication list, and you enter acute medication in the attack entry. The doctor report shows logged migraine days as one total and days with acute medication per month, with no side-by-side comparison.
Can I take my preventive log to the appointment?+
Yes, in the doctor report of the migraine program (a program is its own diary with a doctor report and a monthly questionnaire), a PDF for the period you choose. There is no separate export of the medication list.