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Related Experiment Video

Updated: Jul 4, 2026

MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
08:20

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Published on: August 11, 2015

Rational combination therapy in refractory migraine.

B Lee Peterlin1, Anne H Calhoun, Sherry Siegel

  • 1Department of Neurology, Drexel University College of Medicine, Philadelphia, PA, USA.

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|June 14, 2008
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Summary

Refractory migraine (RM) treatment is challenging. Combination therapy may be effective when single treatments fail, guiding clinicians on rational approaches for persistent headaches.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Refractory migraine (RM) presents significant treatment challenges.
  • RM is defined by a lack of response to standard acute, preventive, and nonpharmacologic therapies.
  • Current treatment often involves combining therapies, though not extensively studied in randomized trials.

Purpose of the Study:

  • To identify patient populations suitable for aggressive combination therapy for RM.
  • To discuss modifiable risk factors and comorbidities associated with migraine.
  • To outline a rational approach to combination therapy and optimal duration for migraine preventatives.

Main Methods:

  • Review of clinical experience and literature regarding refractory migraine treatment.
  • Identification of patient profiles for combination therapy.
  • Discussion of risk factors, comorbidities, and treatment duration.

Main Results:

  • Clinical experience suggests combination therapy can be effective for RM where monotherapy has failed.
  • Specific patient populations can benefit from more aggressive migraine prevention strategies.
  • Understanding modifiable risk factors and comorbidities is crucial for effective management.

Conclusions:

  • Rational combination therapy offers a promising strategy for treating refractory migraine.
  • Further research is needed to fully evaluate the potential of combination treatment for RM.
  • Optimizing treatment duration and addressing comorbidities are key components of managing RM.