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What's New In Migraine Therapy: An Update for Primary Care


What Rx for adolescent migraineurs? Ideal care for menstrual migraine? Perfect patient for new CGRP inhibitors? Answers in this PCP Special Report.

39 million men, women, and children . . . according to the Migraine Research Foundation, that's the estimated number of Americans who deal with migraine headaches. Migraine is world's third most common illness. And nearly 1 in 4 US households include someone with migraine.

There are currently about 16,500 neurologists in this country, and only a few hundred clinicians certified by the United Council for Neurologic Subspecialties to diagnose and treat migraine. So the job of caring for millions who suffer from debilitating episodic bouts falls largely on primary care. And given the enormous time constraints under which most primary care clinicians now practice, getting the diagnosis right and formulating an effective management regimen in collaboration with the patient is an obvious challenge.

So the job of caring for millions who suffer from debilitating episodic bouts [of migraine headaches] falls largely on primary care.

To help you meet that challenge, we offer this Special Report*, in which 3 physicians--all Directors of headache clinics -- outline strategies to effectively manage migraine in people across the lifespan. Some of the topics to be addressed are:

  ► When is migraine prophylaxis appropriate in pediatric patients? Which behavioral interventions are most effective?

  ► Are OTC analgesics appropriate for abortive therapy in adolescents? What are currently recommended maximum daily dosages?

  ► Which triptans are approved for use in patients under age 18 years?

  ► What percentage of women are affected by menstrual migaine? How is menstrual migraine defined by the International Classification of Headache Disorders (ICHD) criteria?

  ► Is one triptan more effective than another in treatment of menstrual migraine? Are herbal preventives effective in migraine of any type?

  ► What medications/medication classes have been shown effective in preventing migriane headache? What are the primary risks and benefits associated with common preventives?

  ► How might the novel class of calcitonin gene-related peptide inhibitors revolutionize migraine prevention? Which patients are likely to be the best candidates for the monocolonal antibodies? 

In the first article, Dariush Saghafi, MD, Director of the Headache Clinic at the Louis Stokes Veterans Administration Medical Center in Cleveland, focuses on some of the more common and successful pharmacological options available to the pediatric and adolescent migraine populations-especially for those aged 15 and older.

Susan Hutchinson, MD, Director of the Orange County Migraine & Headache Center in Irvine, California, addresses the broad topic of migraines and hormones -- and specifically the diagnosis and treatment of menstrual and perimenstrual migraines.

And Peter McAllister, MD, Medical Director of the New England Institute for Neurology and Headache, and Chief Medical Officer of the New England Institute for Clinical Research in Stamford, CT,  will provide you with a working knowledge of the blockbuster new CGRP class of migraine preventive agents that will be available in mid-2018.

But first, see what you already know about migraine and its management by taking a short pre-test. You'll see the same questions at the end of the month, and the answers will be covered in between.

Pre-Test on next page >>


PRETEST: What's New in Migraine Therapy: Update for PCPs


Question 1:

Answer and Question #2 on Next Page »


The correct answer is E. All of the above


Question 2.

Answer and Question #3 on Next Page »


The correct answer is E. All of the above are true


Question 3.

Answer and Question #4 on Next Page »


The correct answer is D. Beta-blockers


Question 4.

Answer and Question #5 on Next Page »


The correct answer is G. All of the above dosages are correct


Question 5.

Answer and Question #6 on Next Page »


The correct answer is C. An opioid such as hydrocodone


Question 6.

Answer and Question #7 on Next Page »


The correct answer is C. It is characterized by bilateral piercing pain around both eyes (False)


Question 7.

Answer on Next Page »


The correct answer is B. False (CGRP inhibitors are for migraine prophylaxis)


Please click on the link below for the next topic in the Patient Care "What's New In Migraine" Special Report for PCPs:

Pediatric and Adolescent Migraine: Update on Treatment Options


PatientCareOnline.com presents a Special Report each month. You can find them by clicking here.

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Primary Care is the Answer to the Migraine Care Gap, Says Headache Specialist
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