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Preventive Treatment 

Preventive Treatment
Preventive Treatment

David W. Dodick

and Stephen D. Silberstein

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date: 19 November 2018

Preventive therapy is used to reduce the frequency, duration, or severity of migraine attacks. Benefits may include the enhancement of response to acute treatments; improvement in function; and the reduction of disability. Prevention is used when (1) migraine attacks significantly interfere with a patient’s quality of life despite appropriate use of acute medications; (2) the patient has frequent headaches (≥ 4 attacks/month or ≥ 8 headache days a month); (3) failure of, contraindication to, overuse, or troublesome side effects from acute medications; (4) patient preference; and (5) hemiplegic migraine; basilar migraine; frequent, prolonged or uncomfortable aura symptoms; or a history of migrainous infarction.

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