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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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Helmi L. Lutsep. Fast Five Quiz: Migraine Headache - Medscape - Jan 26, 2022.
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