A) Primary diagnosis ICHD II Migraine or Chronic Migraine
B) Significant interference with QOL despite
• modification of triggers, lifestyle factors
• adequate trials of acute and preventive medicines
Preventive medicines (at least 3 of 4)
1 Beta Blocker
2 Anticonvulsant
3 Tricyclics
4 Calcium channel blocker
Abortive medicines (all)
1 Both a triptan and DHE intranasal or injectable
2 Either a non steroidal anti-inflammatory drug or combination analgesics
Adequate trial - 2 months/ less if stopped because of adverse effects, with dose being optimal/ maximum tolerated
Modifiers +/-
1 With or without medication overuse
2 With or without significant disability (MIDAS score >11)
B) Significant interference with QOL despite
• modification of triggers, lifestyle factors
• adequate trials of acute and preventive medicines
Preventive medicines (at least 3 of 4)
1 Beta Blocker
2 Anticonvulsant
3 Tricyclics
4 Calcium channel blocker
Abortive medicines (all)
1 Both a triptan and DHE intranasal or injectable
2 Either a non steroidal anti-inflammatory drug or combination analgesics
Adequate trial - 2 months/ less if stopped because of adverse effects, with dose being optimal/ maximum tolerated
Modifiers +/-
1 With or without medication overuse
2 With or without significant disability (MIDAS score >11)
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