Prescribed a new migraine treatment? Use this checklist

People living with chronic migraine experience frequent headache days and migraine attacks. The frequency of those symptoms will vary from one person to the next, but a diagnosis of chronic migraine requires:

• 15 or more headache days per month
• Migraine symptoms on 8 or more of those days
• Symptoms persisting for at least 3 months

As someone living with chronic migraine, it’s important that you take an active role in your treatment, especially when making any decisions about what therapies to use. Below is a list of questions that can help guide you during these conversations with your healthcare provider.

Treatment for chronic migraine

Medications are a mainstay of treatment for chronic migraine. A person with chronic migraine will typically be prescribed two types of therapy:

• A preventive therapy (also called a prophylactic therapy), which is taken continuously. The goal of taking a preventive therapy is to reduce the number of headache days a person experiences each month.
• An acute therapy (also called an abortive therapy), which is taken at the first sign or symptom that a migraine is beginning. The goal of taking an acute therapy is to shorten the duration and lessen the severity of symptoms.

There are many different therapies within these two categories. Finding the right migraine therapy can take time, and a person may need to try different therapies before finding an approach that works.

Also, since chronic migraine requires long-term treatment, a person may need to change therapies from time to time, for a variety of reasons. A person may find that a current therapy is no longer working as well as it used to or causing side effects. A change in insurance can make a different medication more affordable. A healthcare provider may recommend new medication that has become available. Or many other possible reasons.

Questions to ask when changing or starting a treatment

If you are discussing switching medications or starting a new medication, here’s what you will want to discuss with your healthcare provider:

• Know the name of the therapy and the dosage you are prescribed.
• Know the dosing instructions and ask questions if something is unclear.
• Ask your healthcare provider to explain how the therapy works to treat migraines.
• Ask your healthcare provider why they recommend this therapy.
• Ask about the potential side effects, including any risk of serious side effects.
• Ask about potential drug interactions. Your healthcare provider should always have an up-to-date list of all medications you are taking (prescription medications, over-the-counter medications, vitamins, herbal supplements).
• Ask how long it will take before you notice an improvement and how you will follow up about this treatment.
• Ask about the goal of this therapy—for example, how much of a reduction in headache days should you see.
• Ask how long you will be using this therapy.
• Ask what the therapy costs. If you have concerns about the cost, ask who you can talk to about those concerns.
• Ask what other treatment options you have if this treatment does not work.

Remember, any changes to your migraine treatment plan should always be made under the guidance of your healthcare provider.