What is Chronic Migraine?
There are two types of migraine – Episodic Migraine and Chronic Migraine – each determined by frequency of headache days.
Chronic Migraine is a debilitating condition where patients suffer headaches for 15 days or more per month, with migraine on at least 8 of those days. In real terms, this means that a person who suffers from Chronic Migraine has a headache or migraine for more than half the days in the month.
Although Chronic Migraine is distinct from other types of headache and migraine, approximately 80 per cent of people meeting the definition of Chronic Migraine may not have received a diagnosis and may be unaware of specialist care available.
It is estimated that over 345,800 people (aged 18 years and over) in Australia suffer from Chronic Migraine.
Prophylactic/preventive medication is taken daily, monthly or at regular intervals, regardless of whether a headache is present, to reduce the incidence of severe or frequent headaches. These include:
- beta blockers such as propranolol (Inderal), timolol (Blocadren), atenolol (Tenormin) and metoprolol (Lopresor, Betaloc) that block the beta-receptors on which adrenaline works in the nervous system as well as on blood vessels
- serotonin antagonists such as methysergide (Deseril), pizotifen (Sandomigran) and cyproheptadine (Periactin)
- sodium valproate or valproic acid (eg Epilim), an anti-epileptic drug shown to reduce the intensity of migraine
- calcium-channel blockers such as verapamil (Isoptin) that stop the constriction of blood vessels by preventing the use of calcium necessary for this reaction
- antidepressants such as amitriptyline (eg. Tryptanol) have an action on headache that is independent of their antidepressant action
- onabotulinumtoxin A (eg. Botox) is not just a beauty treatment. It has been proven to help those with chronic migraine and is listed on the PBS.
- feverfew, a herbal remedy
- riboflavin 200mg twice daily has been reported as useful.
All are effective. All have side effects and, except feverfew and riboflavin, are prescription drugs. Many were initially introduced for some other problem and were also observed to reduce headache.