Fast Five Quiz: Migraine Headache

Helmi L. Lutsep, MD


January 26, 2022

These may be considered indications for prophylactic migraine therapy:

  • Frequency of migraine attacks is greater than two per month

  • Duration of individual attacks is longer than 24 hours

  • The headaches cause major disruptions in the patient's lifestyle, with significant disability that lasts 3 days or more

  • Abortive therapy fails or is overused

  • Symptomatic medications are contraindicated or ineffective

  • Use of abortive medications more than twice a week

  • Migraine variants such as hemiplegic migraine or rare headache attacks producing profound disruption or risk for permanent neurologic injury

Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are recommended as first-line treatment for migraine prevention. Amitriptyline, venlafaxine, atenolol, and nadolol are indicated as second-line therapy.

Although selective serotonin reuptake inhibitors (SSRIs) are widely used, data regarding their efficacy in migraine prevention are lacking; consequently, SSRIs are not recommended for migraine prevention.

Learn more about the prevention and treatment of migraine headache.

This Fast Five Quiz was excerpted and adapted from the Medscape article Migraine Headache.

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