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Finding the Right Chronic Migraine Treatment

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4 Signs It’s Time to Try a New Chronic Migraine Therapy

Medically Reviewed By Susan W. Lee, DO

Monitoring your symptoms and response to therapy can help you understand the effectiveness of your migraine treatment.


If you live with chronic migraine, you know it can have a significant impact on your life. Chronic migraine is defined as having at least 15 headache days a month for more than 3 months, with at least 8 of those days including migraine headaches.

There are several treatments to help prevent severe symptoms. However, it can take some time to determine which chronic migraine therapy works best for you. You can work with your doctor to adjust your treatment plan.

Evaluate your current migraine treatment

A headache diary can help you examine your current treatment plan. Whether you use pen and paper or an app on your phone, it’s helpful to track the following information:

  • when the headache occurred
  • how long it lasted
  • headache severity
  • medication taken
  • timeline of headache relief
  • effect on daily activities
  • potential triggers, such as sleep quality or menstrual cycle
  • other symptoms, such as nausea or sensitivity to light or sound

With this information, you might find some indications to talk with your doctor about a new chronic migraine treatment. Consider the following scenarios.

1. Your headaches are not improving in frequency or severity

Treatments for chronic migraine are considered preventive therapies. Though they may not eliminate migraine, they should reduce how often your headaches occur and the intensity of your symptoms.

Preventive migraine medications can take a few months to achieve full effect. Yet, if enough time has passed and symptoms are not improving, let your doctor know.

Keep in mind that as your body changes, your medication’s effectiveness can also change. A once helpful migraine treatment may need to be swapped for a new one if, over time, it stops working.

2. You are taking acute migraine medications often

Though preventive therapies are the mainstay for chronic migraine treatment, you’ll likely still need medications to treat migraine headaches when they start. These drugs, called acute migraine treatments, are helpful, but their use should be limited.

A 2022 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggests that if you frequently rely on acute migraine medications, you can make your migraine symptoms severe.

You may also develop secondary headaches, known as medication overuse headaches. This may be a sign that your preventive medication is not working as well as it should. You can talk with your doctor about alternatives.

3. You are experiencing adverse medication side effects

Any time you take a medication, there is a potential for side effects. Let your doctor know if you develop side effects from your migraine treatments. There may be ways to manage them.

However, your doctor may suggest a different treatment if your side effects are significant. There are many classes of medications to treat chronic migraine, such as blood pressure medications, antiseizure drugs, and antidepressants. You may tolerate one type of medication better than another.

Nonpharmacological migraine prevention treatments are also available if you need to avoid medications altogether. These include acupuncture, biofeedback techniques, and massage.

4. You are not taking your migraine prevention medication as directed

Preventive migraine treatments Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source should be administered on a set schedule. Not doing so will decrease their effectiveness.

How often you need to take the medication and its route of administration will vary depending on the drug. For example, some preventive medications, such as propranolol (Hemangeol), are taken daily by mouth. Others, like erenumab (Aimovig), are injected once a month.

If you prefer to avoid taking a daily pill, you could consider a monthly injection. Talk with your doctor about your options.

Out-of-pocket costs, insurance coverage, or access to specific medications can also affect your ability to take your migraine treatment as recommended. Be honest with your doctor if you want to change your treatment plan to see whether adjustments can be made.


Chronic migraine Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source can affect your work performance, time spent with family, and your relationships. An effective chronic migraine treatment should do more than just reduce your headaches — it should enhance your daily life.

If your current treatment is ineffective, you can consider exploring other options.

In addition to current therapies, advances in migraine treatment are continuously evolving. Work with your doctor to find a treatment plan that best suits your needs.

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Medical Reviewer: Susan W. Lee, DO
Last Review Date: 2024 Feb 7
View All Finding the Right Chronic Migraine Treatment Articles
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