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Questions and Answers
Which medication is the first-line choice for migraine prophylaxis?
Which medication is the first-line choice for migraine prophylaxis?
- Mirtazapine
- TCAs (correct)
- Venlafaxine
- SSRIs
When is prophylaxis appropriate for chronic headaches?
When is prophylaxis appropriate for chronic headaches?
- When headaches last more than 2-3 hours
- When headaches occur at least once a week
- When headaches result in medication overuse or disability (correct)
- When headaches occur less than twice a week
Which medication may be useful for chronic headaches without depression?
Which medication may be useful for chronic headaches without depression?
- Venlafaxine
- Gabapentin
- Topiramate (correct)
- Tizanidine
What is the potential benefit of lidocaine trigger point injections?
What is the potential benefit of lidocaine trigger point injections?
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What is the efficacy of botulinum toxin injections for chronic headaches?
What is the efficacy of botulinum toxin injections for chronic headaches?
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Study Notes
Migraine Prophylaxis
- Topiramate is the first-line choice for migraine prophylaxis.
Prophylaxis Indications
- Prophylaxis is appropriate for chronic headaches when the patient experiences 15 or more headache days per month.
Treatment Options
- Valproate may be useful for chronic headaches without depression.
Lidocaine Injections
- Lidocaine trigger point injections may provide a potential benefit of immediate pain relief.
Botulinum Toxin Injections
- Botulinum toxin injections have a 50% response rate for chronic headaches, meaning that 50% of patients experience a 50% or greater reduction in headache frequency.
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