Fast Five Quiz: Chronic Migraine Prevention

Stephanie J. Nahas, MD, MSEd; Helmi L. Lutsep, MD


February 04, 2022

The goals of preventive therapy are to decrease the frequency, severity, and duration of migraine attacks. Preventive therapy may also improve responsiveness to acute migraine therapy and enhance patients' quality of life. Indications for prophylactic migraine therapy may include:

  • Frequency of migraine attacks: more than two per month

  • Duration of individual attacks: longer than 24 hours

  • Major disruptions in the patient's lifestyle, with significant disability that lasts 3 days or more

  • Failure or overuse of abortive therapy

  • Contraindications or inefficacy of symptomatic medications

  • Use of abortive medications more than twice per week

Preventive therapy may also be indicated in patients who experience hemiplegic migraine or rare headache attacks that produce profound disruption or risk for permanent neurologic injury.

Learn more about emerging data on the management of chronic migraine.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.