Part II: Preventing & Reversing Chronic Migraine
Key Questions
- How does a provider assess a patient’s risk of progressing from episodic to chronic migraine disease?
- When should acute migraine treatments alone be considered insufficient to treat migraine?
- What roles do acute and preventive treatments play in managing migraine?
- What treatment approaches (medications, neuromodulation devices, or lifestyle modifications) can be useful for preventing progression?
- Why is chronic migraine often underdiagnosed and undertreated?
- Is it possible for a person to reverse chronic migraine?
- What role does neuroplasticity play in the progression to and reversal of chronic migraine?
- What are some of the questions a provider might consider when evaluating why a person with chronic migraine has not responded to treatment?
- What are some of the specific conditions with which chronic migraine disease might be confused?
- Are new or more targeted therapies available and under development for managing migraine disease?
Interview Notes
- Richard B. Lipton, MD
- Montefiore Headache Centre
- International Classification of Headache Disorders Third Edition (ICHD-3)
- Rami Burstein
- Study: “Reversion from chronic migraine to episodic migraine in patients treated with fremanezumab: Post hoc analysis from HALO CM study”
- Study: “Brain changes in responders vs. non-responders in chronic migraine: Markers of disease reversal”
Treatments Mentioned
- Atogepant (Qulipta/Aquipta)
- Caffeine
- CEFALY
- CGRP monoclonal antibodies (mAbs)
- Cognitive behavioral therapy (CBT)
- Cognitive behavioral therapy for insomnia (CBT-I)
- Divalproex sodium
- Exercise
- Fremanezumab (Ajovy)
- CGRP small-molecule receptor antagonists (gepants)
- Indomethacin
- Ketamine
- Neuromodulation devices
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Nutritional counseling
- OnabotulinumtoxinA (Botox)
- Psychedelics
- Rimegepant (Nurtec ODT/Vydura)
- Transcutaneous electrical nerve stimulation (TENS)
- Topiramate (Topamax)
- Transcranial magnetic stimulation (TMS)
- Triptans
- Ubrogepant (Ubrelvy)
- Vagus nerve stimulation
- Zavegepant (Zavzpret)
Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.
Richard B. Lipton, MD
Professor of Neurology & Director of the Montefiore Headache Center, and Director of the Division of Cognitive Aging and Dementia
Albert Einstein College of Medicine
Dr. Richard B. Lipton is an expert in headache and migraine management, as well as cognitive aging and dementia. He serves as the director of the Montefiore Headache Center and holds the prestigious Edwin S. Lowe chair in neurology at Albert Einstein University in New York. Internationally acclaimed for his contributions to headache diagnosis, classification, epidemiology, and treatment, Dr. Lipton has an impressive bibliography with 11 books and over 1,000 articles in indexed journals. His textbook, Headache in Clinical Practice, earned him the Medical Book Award from the British Medical Association.
He is past president of the American Headache Society (AHS), and is an associate editor for Cephalalgia: An International Journal of Headache. Additionally, he contributes to several other editorial boards, including for Neurology. His outstanding research has been recognized six times with the Harold G. Wolff Lecture Award from the AHS. Beyond neurology, Dr. Lipton is also a professor in psychiatry, behavioral sciences, epidemiology, and population health at the Albert Einstein College of Medicine.
For a limited time get up to 21% OFF all the 2025 interviews, videos, audio, transcripts, and more. Why upgrade?
- Can’t attend live? Watch anytime
- Prefer reading or listening? Get transcripts and audio
- Want to dive deeper? Explore the additional footage & resources
- Need ongoing support? Reference expert advice year-round
- Lifetime access to 2025, no annual fee
- Act now, early-bird offer ends March 19th!
Related Talks for: Day 3 (2025)
How Poor Sleep Worsens Migraine: What You Need to Know
Lauren R. Natbony, MD, FAHS
How Sinuses, Allergies & Weather Affect Migraine
Vince Martin, MD, AQH
Migraine’s Comorbidities: A Look at Associated Conditions
Peter McAllister, MD, FAAN
Miles for Migraine is a registered 501(c)(3) nonprofit organization with the mission of improving the lives of people with migraine and other headache disorders, and their families, by raising public awareness about this disease, and helping to find a cure. Miles for Migraine produces fun walk/run events, typically a 2-mile walk and 5K and 10K races to raise money for migraine research. We also host adult education days, and a youth program for kids and teens impacted by migraine and other headache disorders.
Pfizer's purpose is breakthroughs that change patients’ lives. We pursue that goal relentlessly and innovate every day to make the world a healthier place. It was Charles Pfizer’s vision at the beginning and it holds true today.
You're not alone—many could benefit from these expert insights. Invite a friend, family member, caregiver, or healthcare provider to watch. Give the gift of health with an All Access Pass. Share the knowledge, make a difference!
