For a young woman with severe, throbbing headaches and a normal MRI, which medication is best for reducing headache frequency?

Propranolol is an effective medication for reducing the frequency of migraines and is commonly used as a preventive treatment. It belongs to a class of drugs known as beta-blockers, which have been shown to help decrease the frequency and severity of migraine attacks by stabilizing vascular tone and inhibiting the release of neurotransmitters that can trigger headaches.

In the case of a young woman experiencing severe, throbbing headaches with a normal MRI suggesting that there are no secondary causes of her pain, propranolol is particularly suitable because it can be utilized for migraine prophylaxis and has a favorable side effect profile compared to other medications.

While other options may provide some relief, they are not primarily used for reducing the frequency of migraines. Sumatriptan, for instance, is an acute treatment designed to alleviate headache during an attack rather than prevent future headaches. Isometheptene is also used for acute headache relief. Hydrocodone is an opioid that may be used for pain management but is not indicated for migraine prevention and carries risks of dependency and rebound headaches.