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
Jan Lewis Brandes, MD

Jan Lewis Brandes, MD

Assistant Clinical Professor of Neurology
Vanderbilt University

Jan Lewis Brandes, M.D., M.S., holds an appointment as an assistant clinical professor in the department of neurology at Vanderbilt University School of Medicine, Nashville, Tennessee; she is also the founding director of the Nashville Neuroscience Group, a private headache clinic in Nashville, Tennessee. Prior to attending Vanderbilt University School of Medicine, where she subsequently earned her medical degree, Dr. Brandes attended the Robert Koch Institute of Virology, Free University, in Berlin, Federal Republic of Germany, as a Fulbright Scholar. Her postgraduate medical training was completed at Vanderbilt University Medical Center, where she served as chief resident in neurology. She also holds an M.S. degree in microbiology from the University of Tennessee in Knoxville. She is certified by the National Board of Medical Examiners, the American Board of Psychiatry and Neurology, the National Board for Certification in Headache Management, and is UCNS-certified in headache medicine.

Dr. Brandes has been active in clinical trials for more than two decades. She has served as the principal or co-principal investigator in more than 100 studies, primarily examining issues in migraine including acute treatment, prophylaxis, and menstrual migraine. She has published extensively in peer-reviewed journals including JAMA, Cephalalgia, Headache, and Lancet Neurology.

Dr. Brandes is a fellow of the American Headache Society and the American Academy of Neurology. She is a former member of the board of directors of the American Headache Society, and is the past-president of the American Council for Headache Education.  In recognition of her professional endeavors, she has been named to Best Doctors in America from 1996 to present.

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