Preventing Attacks Before They Happen

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Key Questions
  • When is preventive therapy for migraine recommended?
  • Why is frequent use of acute migraine medications a problem?
  • What are the major classes of medications for migraine prevention?
  • How can an ineffective acute treatment lead to migraine chronification?
  • What can we expect when our doctor puts us on preventive therapy?
  • Why are migraine diaries important for migraine prevention?
  • Are the CGRP medications effective in patients who haven’t responded to other therapies?
  • What is polytherapy?
  • When acute migraine medications don’t seem to be working, what can we do?
  • Why would it be helpful for your provider to have your complete medical history, going back to childhood?
  • Why are some patients labeled difficult to treat?
  • Can adverse childhood experiences have an effect of migraine?
Interview Notes
photo of a woman with brown hair

Jan Lewis Brandes, MD

Assistant Clinical Professor of Neurology | Founder
Vanderbilt University | Nashville Neuroscience Group

Jan Lewis Brandes, MD, MS, holds an appointment as an assistant clinical professor in the Department of Neurology, Vanderbilt University School of Medicine, and is the founder and director of the Nashville Neuroscience Group, both in Nashville, Tennessee. After finishing her medical degree at Vanderbilt University School of Medicine, she completed her postgraduate education in neurology, serving as chief resident. Her earlier graduate work centered on molecular virology, as a Fulbright Scholar at the Robert Koch Institute of Virology, Free University of Berlin, and at the University of Tennessee, Knoxville, where she earned a master’s degree in microbiology. She holds board certification from the American Board of Psychiatry and Neurology and has been UCNS-certified in headache medicine.

Dr. Brandes has served as the principal or co-principal investigator in more than 100 clinical trials for headache management. She has authored more than 150 publications in peer-reviewed journals, and her most recent focus has been on expanding enrollment in pregnancy registries, particularly those related to the use of CGRP monoclonal antibodies during pregnancy, and in education regarding hormonal management of migraine.

Dr. Brandes served on the board of directors of the National Headache Foundation for more than a decade, where she was involved in educational programming and patient advocacy. She is a past fellow of the Academy of Neurology, and of the American Headache Society, where she served on the board of directors. She also is the past president of the American Council for Headache Education.

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