From the Headache and Pain Management Programs, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
General Principles of Migraine Management: The Changing Role of Prevention
Article first published online: 5 APR 2005
Headache: The Journal of Head and Face Pain
Volume 45, Issue Supplement s1, pages S33–S47, April 2005
How to Cite
Loder, E. and Biondi, D. (2005), General Principles of Migraine Management: The Changing Role of Prevention. Headache: The Journal of Head and Face Pain, 45: S33–S47. doi: 10.1111/j.1526-4610.2005.4501002.x
- Issue published online: 5 APR 2005
- Article first published online: 5 APR 2005
The role of preventive treatment in the management of migraine must be reassessed. Many patients who would benefit from preventive therapy do not receive it, and many might benefit from earlier and more aggressive use of preventive therapy. Physicians who treat migraine have long recognized that a subset of patients with episodic migraine evolve to chronic forms of the disorder that are difficult to treat and have a poor outcome. This article reviews the evidence for current and emerging prophylactic migraine treatment and raises the possibility that timely use of prophylactic treatment might modify or prevent the transformation to chronic migraine and the extreme disability that characterizes a small but significant subset of the migraine population. Along with aggressive treatment of the acute pain and other symptoms of migraine, prevention of progression to severe forms of this disorder will increasingly be a focus and goal of the treatment.