For patients with chronic migraine (≥15 headaches/month), preventive treatment is recommended by migraine-prevention guidelines as the standard of care; however, whether patients actually adhere to prophylactic therapy is questionable. A new study published in the journal Cephalalgia aims to discover which oral migraine-preventive medications are tied to better patient adherence. Fourteen commonly prescribed drugs were included in the study: amitriptyline, nortriptyline, citalopram, sertraline, fluoxetine, paroxetine, venlafaxine, propranolol, metopralol, atenolol, nadolol, divalproex, gabapentin, and topiramate. Of the 8,688 eligible study participants, adherence to an oral prophylactic migraine treatment ranged from 26–29% at 6 months and dropped to 17–20% at 12 months. Adherence did not vary much between treatments, except with amitriptyline, nortriptyline, gabapentin, and divalproex; these drugs had significantly lower odds of adherence vs. topiramate. Regardless of which drug was prescribed, adherence to oral migraine-preventive medications amongst chronic migraine sufferers was low. The authors conclude that more research needs to be done to understand the reasons for non-adherence and to help develop strategies for better patient adherence.
Chronic migraine (CM) is a disabling disorder characterized by ≥15 headache days per month that has been shown to significantly reduce quality of life.