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When should “chronic migraine” patients be considered “refractory” to pharmacological prophylaxis?

  • Drug-Resistant Primary Headaches
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Abstract

Patients with chronic headache forms evolving from a previous episodic migraine (‘chronic migraine’) are often difficult to treat. In this paper we focus attention on aspects we believe important for producing a definition of “refractory” in relation to this headache form. We propose a “chronic migraine” patient should be considered “refractory” to pharmacological prophylaxis when adequate trials of preventive therapies at adequate doses have failed to reduce headache frequency and improve headache-related disability and, in patients with medication overuse, reduce the consumption of symptomatic drugs. However before a definition of “refractory” chronic migraine can become established, generally accepted diagnostic criteria and treatment guidelines for this condition need to be developed.

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Authors and Affiliations

  1. Department of Clinical Neurosciences, C. Besta Neurological Institute, Via Celoria 11, 20133, Milan, Italy

    Domenico D’Amico, Massimo Leone, Licia Grazzi & Gennaro Bussone

Authors
  1. Domenico D’Amico
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  2. Massimo Leone
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  3. Licia Grazzi
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  4. Gennaro Bussone
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Correspondence to Domenico D’Amico.

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D’Amico, D., Leone, M., Grazzi, L. et al. When should “chronic migraine” patients be considered “refractory” to pharmacological prophylaxis?. Neurol Sci 29 (Suppl 1), 55–58 (2008). https://doi.org/10.1007/s10072-008-0888-3

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  • DOI: https://doi.org/10.1007/s10072-008-0888-3

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