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4yr

50-year-old female reports having ~10 migraine days per month with some migraine attacks lasting longer than 12 hours. She is currently on topiramate for migraine prevention and has escalated through various acute medications/combinations with  increasing use recently. As a working mother with three school-aged children, her increased absenteeism and presenteeism is causing her substantial anxiety and stress.

Currently, this patient has a BMI of 26 and is post-menopausal.

What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?

  • 4yr
    Possibly use an abortive Rxs, the goal of abortive treatment is to stop a migraine once it starts. Use of CGRP antagonists - rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) or Show More
  • 4yr
    I would start her on aiMovie do to the number of headaches and the disruption of her life

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  • Saved

4yr

50-year-old female reports having ~10 migraine days per month with some migraine attacks lasting longer than 12 hours. She is currently on topiramate for migraine prevention and has escalated through various acute medications/combinations with  increasing use recently. As a working mother with three school-aged children, her increased absenteeism and presenteeism is causing her substantial anxiety and stress.



Currently, this patient has a BMI of 26 and is post-menopausal.



What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?


  • 4yr
    Possibly use an abortive Rxs, the goal of abortive treatment is to stop a migraine once it starts. Use of CGRP antagonists - rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) or Show More
  • 4yr
    I would start her on aiMovie do to the number of headaches and the disruption of her life

Show More Comments

  • Saved

4yr
Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review - Current Pain and Headache Reports

Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review - Current Pain and Headache Reports

Source : https://link.springer.com/article/10.1007/s11916-021-00996-7

Purpose of Review This review aims to discuss the experience of migraine in transgender and gender-diverse individuals as it relates to other psychiatric comorbidities such as anxiety, depression, PTSD, and...


Summary: Research has demonstrated that stigma and discrimination can affect health outcomes in the transgender and gender-diverse community. A recent study has shown that sexual minority stress associated with stigma, discrimination, and barriers to care can exacerbate migraine. It is known that psychiatric comorbidities such as anxiety,...

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4yr
Increase in ACC GABA+ levels correlate with decrease in migraine frequency, intensity and disability over time - The Journal of Headache and Pain

Increase in ACC GABA+ levels correlate with decrease in migraine frequency, intensity and disability over time - The Journal of Headache and Pain

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-021-01352-1

Background An imbalance between inhibitory and excitatory neurometabolites has been implicated in chronic pain. Prior work identified elevated levels of Gamma-aminobutyric acid + macromolecules ("GABA+") using magnetic resonance spectroscopy (MRS)...


Conclusion: The correlation between an increase in ACC GABA levels with improvement in clinical characteristics of migraine, suggest previously reported elevated GABA levels may not be a cause of migraine, but a protective mechanism attempting to suppress further migraine attacks.

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4yr
Erenumab Decreases Headache-Related Sick Leave Days and Health Care Visits: A Retrospective Real-World Study in Working Patients with Migraine - Neurology and Therapy

Erenumab Decreases Headache-Related Sick Leave Days and Health Care Visits: A Retrospective Real-World Study in Working Patients with Migraine - Neurology and Therapy

Source : https://link.springer.com/article/10.1007/s40120-021-00303-x

Introduction The prevalence of migraine is highest among working age individuals, and this disease is associated with an increased number of sick leaves and health care visits, as well as...


Conclusions: The results of this registry study suggest that in addition to the effect on the monthly number of migraine days documented in clinical trials, erenumab can significantly reduce the number of headache-related sick leave days and health care visits in employed patients with migraine managed in routine clinical practice.