Told You’re “Out of Options”? There’s Hope
Key Questions
- How is treatment-resistant (or refractory) migraine defined?
- How can a patient determine whether all reasonable treatment options have been exhausted or whether a different approach may be needed?
- What role does integrative headache medicine play in migraine care?
- Which complementary or integrative approaches can be used alongside an existing treatment regimen?
- What is medication overuse headache (MOH), and how does it develop?
- What approaches are used to manage MOH in individuals with chronic migraine?
- What practical strategies can support care management and improve communication with healthcare providers?
- What guidance is available for individuals with limited access to migraine treatments?
- What strategies support patients in coping with the emotional impact of treatment failure or unmet expectations?
- What strategies can support coping with treatment-resistant migraine?
- How has your personal experience with migraine shaped your clinical practice?
Interview Notes
- Lauren R. Natbony, MD, FAHS | Integrative Headache Medicine of New York
- Instagram: @laurennatbonymd
- Facebook: Dr. Lauren R. Natbony
- LinkedIn: Lauren R. Natbony, MD, FAHS
- X: @LaurenNatbonyMD
Treatments Mentioned
- Acetaminophen
- Acupuncture
- Aspirin/acetasylic acid (ASA)
- CGRP monoclonal antibodies (mAbs)
- Small-molecule CGRP receptor antagonists (gepants)
- Combination analgesics
- Exercise
- Infusion therapy
- Layering approach
- Nerve blocks
- Neuromodulation devices
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Online care/therapy
- Opiates
- Physical therapy
- Rimegepant (Nurtec ODT)
- Self-modulation/self-regulation
- Sleep evaluation
- Steroids
- Supplements
- Targeted massage
- Triptans
- Ubrogepant (Ubrelvy)
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Disclaimer: The Migraine World Summit aims to bring you a variety of perspectives and expertise, free from 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.
Lauren R. Natbony, MD, FAHS
Founder & Medical Director
Integrative Headache Medicine of New York
Lauren R. Natbony, MD, FAHS, is a board-certified neurologist and fellowship-trained headache specialist and the founder and medical director of Integrative Headache Medicine of New York. She is also an assistant clinical professor of neurology in the Division of Headache and Facial Pain at Mount Sinai’s Icahn School of Medicine.
Dr. Natbony received her undergraduate degree from Stanford University and her medical degree from the University of Miami Leonard M. Miller School of Medicine. Dr. Natbony completed her internship in internal medicine and residency in neurology at the University of Pittsburgh Medical Center, followed by a fellowship in headache medicine at the Icahn School of Medicine at Mount Sinai. She also received advanced training and certification in medical acupuncture at Harvard Medical School. She is board certified in neurology by the American Board of Psychiatry and Neurology, and in headache medicine by the United Council of Neurologic Subspecialties. Dr. Natbony has been named a fellow of the American Headache Society (FAHS), a reflection of her professional and scholarly achievements in headache medicine.
Dr. Natbony is a frequent speaker at national headache conferences and provides educational lectures to healthcare professionals worldwide to improve migraine and headache care. Her work can be found in multiple textbooks and peer-reviewed journals, including Headache and Current Pain and Headache Reports. Dr. Natbony conceptualized and authored the book Integrative Headache Medicine: An Evidence-Based Guide for Clinicians, which provides illuminating, evidence-based approaches for combining traditional medical therapies with alternative treatments for headache. Dr. Natbony is also a mother, an acupuncture and lifestyle medicine expert, and someone who experiences both migraine and headaches. Her practice focuses on empowering patients with integrative healing tools by creating individualized holistic treatment plans. Dr. Natbony has been a featured expert on the Today show, Self magazine, Good Morning America, Time magazine, and other media.
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