Preventive Therapy of Migraine

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Purpose of Review: This article reviews the preventive therapy of migraine, including indications, strategies for use, and available treatments. Recent Findings: Lifestyle modifications and migraine trigger avoidance are recommended as preventive measures for all individuals with migraine. The decision to recommend additional migraine preventive therapy should consider the frequency of migraine attacks and headaches, extent of migraine-associated disability, frequency of using acute migraine treatments and the responsiveness to such treatments, and patient preferences. Additional therapies include prescription medications, nutraceuticals, neurostimulation, and behavioral therapy. Considering evidence for efficacy and the risk of potential side effects and adverse events, treatments with the most favorable profiles include (in alphabetical order): amitriptyline, beta-blockers (several), biofeedback, candesartan, coenzyme Q10, cognitive-behavioral therapy, magnesium citrate, onabotulinumtoxinA (for chronic migraine only), relaxation therapy, riboflavin, and topiramate. In addition, erenumab, a calcitonin gene-related peptide (CGRP) receptor monoclonal antibody, received approval from the US Food and Drug Administration (FDA) for the prevention of migraine in May 2018. Summary: Successful migraine preventive therapy reduces the frequency and burden of attacks while causing limited side effects. Individual treatment recommendations are determined based upon evidence for efficacy, side effect and adverse event profiles, medication interactions, patient comorbidity, costs, and patient preferences. Patients must be counseled on reasonable expectations for their preventive therapy and the importance of adhering to the recommended treatment plan for a period of time that is sufficient to determine outcomes.

Original languageEnglish (US)
Pages (from-to)1052-1065
Number of pages14
JournalCONTINUUM Lifelong Learning in Neurology
Volume24
Issue number4-Headache
DOIs
StatePublished - Aug 1 2018

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Migraine Disorders
Therapeutics
coenzyme Q10
Patient Preference
Calcitonin Gene-Related Peptide Receptors
Relaxation Therapy
Amitriptyline
Riboflavin
Cognitive Therapy
United States Food and Drug Administration
Dietary Supplements
Prescriptions
Life Style
Comorbidity
Monoclonal Antibodies
Costs and Cost Analysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

Cite this

Preventive Therapy of Migraine. / Schwedt, Todd J.

In: CONTINUUM Lifelong Learning in Neurology, Vol. 24, No. 4-Headache, 01.08.2018, p. 1052-1065.

Research output: Contribution to journalReview article

Schwedt, Todd J. / Preventive Therapy of Migraine. In: CONTINUUM Lifelong Learning in Neurology. 2018 ; Vol. 24, No. 4-Headache. pp. 1052-1065.
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