The kind of patient who is suitable for preventive medication in migraine are patients who suffer from frequent and disabling migraine attacks.
Sometimes they don’t need to have a lot of days, but if those days are really disabling then, sometimes they are candidates for prevention. The current options for preventive therapy in episodic migraine are oral preventives and the problem that we mainly find is that the tolerability is not that great.
They have plenty of adverse events. Really, I have sometimes a feeling that I not sure if we are doing more harm than good, which is not the goal.
It’s hard to find the right preventive treatment for our patients and many times we need to do combinations.