Fast Five Quiz: Overview of Chronic Migraine

Jasvinder Chawla, MD, MBA; Heidi Moawad, MD


June 27, 2023

Treatment of chronic migraine must take a multifaceted approach to include risk factor modification, avoidance of migraine triggers, nondrug and drug-based prophylaxis, and abortive migraine treatment, with consideration to avoid drug overuse. All of these treatment aspects work together to lessen migraine frequency and severity and to slow, or even stop, the progression from episodic to chronic migraine, which in turn improves patient quality of life.

Acute overuse of abortive migraine therapy is considered one of the most important risk factors for the chronification of migraine. Medication overuse can occur with any analgesic, including acetaminophen or nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen, and aspirin, but also with opiates, barbiturates, and triptans. These agents are protective in patients with fewer than 10 headache days at baseline but induce migraine progression in patients with more frequent headaches. Reversing medication overuse is one of the important modifiable risk factors in patients with migraine, and about 26% of patients with chronic migraine go into remission within 2 years of chronification.

Learn more about the treatment of chronic migraine.

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