Medication for Prevention: Know Your Options

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Key Questions
  • What are the differences between acute therapies and preventive therapies for migraine?
  • How does a physician decide where to start with a patient if it’s determined that they do need some kind of preventive?
  • Why are medications developed for other conditions, such as hypertension and epilepsy, helpful in migraine prevention?
  • What are some of the neuromodulation devices available and how can they help with migraine prevention?
  • How effective has Botox proven to be as a migraine preventive?
  • How do the anti-CGRP treatments compare to the other “off label” preventive treatments that have been around longer, such as Botox, topiramate, and propranolol?
  • Can a combination of pharmaceuticals, neuromodulation devices, and alternative or natural treatments be synergistic in migraine treatment?
  • How effective are supplements such as magnesium, riboflavin, butterbur, and feverfew in migraine prevention?
  • Is it recommended or even possible to combine two preventive pharmaceuticals, such as Botox and CGRP treatments?
  • How long does a patient need to be on a particular preventive treatment therapy or approach before they can determine if it’s working?
  • What are the guidelines for preventive therapies based on migraine frequency i.e. for patients with high frequency versus low frequency per month?
Interview Notes

Find more about Anna Andreou, PhD and her work here:

profile-anna-andreou

Anna Andreou, PhD

Director of Headache Research
The Headache Centre, GSTT & King's College London, UK

Anna Andreou is the director of headache research at The Headache Centre, Guy’s and St. Thomas’ NHS Trust and Wolfson CARD, King’s College London. Dr. Andreou completed her PhD in neurology at the Institute of Neurology, Queen Square, where she investigated the therapeutic potentials of novel pharmacological innovations in migraine treatment. She then moved to the University of California, San Francisco, where she focused her research on the investigation of brain networks involved in headache pathophysiology and the effectiveness of neurostimulation in migraine. Dr. Andreou is now the senior Migraine Trust fellow based at the Wolfson CARD, King’s College London. Since the completion of her PhD, Dr. Andreou received a number of awards including the Thomas E. Heftler Migraine Research Award by the American Headache Society, the Early Research Career Grant by the International Association for the Study of Pain, and the Headache Research Excellence award from the International Headache Society. She is also a co-recipient of the Enrico Greppi Award in 2010, and she is a two-time recipient of the European Headache Migraine Trust International Congress New Scientist Lecture and the American Headache Society “Frontiers in Headache Research” Scholarship Award. Dr. Andreou served as the chair of the Trainees and Residents SIG of the International Headache Society for four years and she is now a chair of the IHS electronics media committee.

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