[Determinants of prophylactic migraine therapy in Spain]

Migraine interferes with the quality of life of patients. Prophylactic medication is an option to be considered in cases showing inefficiency of symptomatic medication or an increase in the number of attacks.

To evaluate the characteristics of patients that start on prophylactic treatment for migraine.

A multicenter epidemiologic survey was conducted in 110 neurological outpatient clinics and hospitals among adult patients of both sexes who required prophylactic treatment for migraine. Pain intensity was measured through a three-category scale: mild, moderate, or severe. Daily disability was measured by a disability questionnaire.

A total of 735 patients with migraine who had started prophylactic treatment were considered valid for the analysis. The patients reported an average of 9.7 days with migraine in the previous month, 32% of the episodes lasting more than 24 hours. Half of the patients referred working or home disability due to migraine with a total average score of 15.1 on the disability scale (grade III). A 48% of the patients had previously received prophylactic treatment, the medications most commonly prescribed being flunarizine, propranolol and amitriptyline. At the study visit, the most commonly prescribed medications were topiramate, flunarizine, propranolol, and amitriptyline.

Our study reveals that starting prophylactic treatment is in the majority of cases due to a high attack frequency. A clear evolution is being observed in prophylactic medication prescription, with a shift from flunarizine or propranolol to topiramate, which is prescribed more frequently nowadays.