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TREAT migraine early and effectively for best results1-3

  • The best chance of alleviating symptoms
  • A reduced impact on patients’ lives

When your patient comes to you with headache, remember to THINK TALK TREAT Migraine®

Four key signs and symptoms: headache, impact, photophobia, nausea. Think Migraine One key Question: How many days a month does headache impact your life? Talk Migraine One key answer: 1 day/month or more equals acute plus prevention. Treat Migraine
Learn when to recommend an acute or a preventive treatment.
There are 2 types of migraine treatment: acute and preventive
If your patients with headache have their daily activities impacted 1 or more days per month, then acute treatment is recommended.2*
If your patients with headache have their daily activities impacted 4 or more days per month, acute and preventive treatment is recommended.2*

* Recommended medications refer to those with established/probable efficacy as identified by the AAN/AHS guidelines and the AHS position statement regarding new migraine treatments.2

The goal of acute treatment includes4:

  • TREAT migraine attacks before they worsen
  • Restore ability to function

The goal of preventive treatment includes5:

  • Stop migraine attacks before they happen
  • Reduce migraine attack frequency, severity, and duration
  • Improve quality of life (eg, MSQ)

The AHS provides an evidence assessment for migraine treatment. Recommended medications supported by Level A† or B‡ evidence include2:

Acute TreatmentsPreventive Treatments
Acute Treatments:
  • Antiemetics
  • Combination medications
  • Ditans
  • Ergotamine and other forms of dihydroergotamine
  • Gepants (CGRP oral antagonists)
  • Isometheptene-containing compounds
  • NSAIDs
  • Triptans
 Preventive Treatments:
  • Antidepressants
  • Antiepileptics
  • Beta-blockers
  • CGRP monoclonal antibodies
  • Gepants (CGRP oral antagonists)
  • OnabotulinumtoxinA§

† Level A: Effective based on available evidence (more than 2 Class I studies).
‡ Level B: Probably effective based on available evidence (1 Class I or 2 Class II studies).
§ For chronic migraine only.

Set realistic treatment goals, expectations, and timelines with your patients to ensure they adhere to treatment and know what to expect.2

  • For example, before lack of effectiveness can be determined, prevention plans should be followed for a minimum of 3 months at a target therapeutic dose for oral treatments

Learn more about recommended treatments in the AHS consensus statement

Learn more about assessing your patients' response to treatment

AAN=American Academy of Neurology; AHS=American Headache Society; CGRP=calcitonin gene-related peptide; MSQ=Migraine-Specific Quality of Life Questionnaire; NSAID=nonsteroidal anti-inflammatory drug.

References:

  1. Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine™ validation study. Neurology. 2003;61;375-382.
  2. Ailani J, Burch RC, Robbins MS; Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039. doi:10.1111/head.14153
  3. Buse DC, Greisman JD, Baigi K, Lipton RB. Migraine progression: a systematic review. Headache. 2019;59:306-338.
  4. Ong JJY, De Felice M. Migraine treatment: current acute medications and their potential mechanisms of action. Neurotherapeutics. 2018;15(2):274-290.
  5. Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Physician. 2006;73(1):72-78.