Abstract

Migraine is a chronic recurrent headache disorder and preventive medications can lessen the burden or disability due to severe migraine attacks. About a half of patients responded(a greater than 50% reduc- tion in either mean migraine frequency or mean numbers of days with migraine) to traditional preventive medications and some gave up the medications due to adverse effect before the maximum effects. Causes of failure to preventive medications were poor compliance or premature discontinuation, inappropriate choice of medications, or neglect the exacerbating factors in habit or environment. The frequency of mig- raine can change purely with time, so non-pharmacological management is worthwhile after comprehen- sive evaluations for primary or secondary headache. The patients with previous failure of several courses of preventive medications can respond to new preventive therapy or combined therapy with previous par- tial effective medications. Korean Journal of Headache 6(1):70-73, 2005