Great news for people with chronic migraine

A migraine is not just a bad headache. It’s a specific type of headache. And it often needs specific types of treatment.

Around 1 in 5 Australians will suffer from migraine at some point in their lives.

And for some, episodes of migraine will be far too frequent. They will develop what we call chronic migraine.

What is chronic migraine?

Chronic migraine is where someone has a migraine attack on 15 or more days per month, each month, for three or more months.

Symptoms of chronic migraine include headache, aura, or both. Chronic migraine can be limiting at best and debilitating at worst.

A migraine attack could disrupt your routine at any time. This impacts work life, social commitments, and relationships.

Managing chronic migraine

Individual episodes of migraine can be managed with what we call ‘acute’ treatment. This includes:

• paracetamol
• non-steroidal anti-inflammatory drugs such as ibuprofen or diclofenac
• triptans such as sumatriptan, that more selectively target migraine headaches
• medicines to deal with nausea and vomiting (antiemetics)

But using medicines like this too often can become problematic. This is where preventative medications become important.  

Several different classes of medicines can help with chronic migraine.

• Blood pressure medications
  • Beta-blockers – propranolol, metoprolol
  • Calcium channel blockers – verapamil
• Antidepressants
  • Tricyclic antidepressants – amitriptyline, nortriptyline
  • SNRIs – venlafaxine, duloxetine
• Antiepileptics
  • Topiramate
  • Sodium valproate
  • Gabapentin
• Other
  • Pizotifen
  • Cyproheptadine

Has your migraine preventer prescription run out? Order a repeat here.

Click here for more information on non-prescription therapies and lifestyle tips for migraine.

The new kids on the block

In recent years, targeted therapies have been specifically developed to treat chronic migraine. And as of mid-2021, people with chronic migraine in Australia have access to more options.

Monoclonal antibodies

The calcitonin gene-related peptide (CGRP) monoclonal antibodies are a new class of medicines for migraine. They can reduce migraine frequency, without serious side effects. They are given once a month as an injection under the skin.

In Australia, a neurologist can prescribe a CGRP monoclonal antibody (at a subsidised cost) if:

• a patient has chronic migraine AND
• has failed to improve with three oral preventative medicines or could not tolerate them

These medicines join the other recent recruit to managing chronic migraine: botox.

Botulinum toxin A

Botulinum toxin A (‘botox’) is given as injections every 3 months around the forehead, scalp, and shoulders. It slowly reduces migraine frequency and severity by altering the chemical messengers that cause migraine.

In Australia, chronic migraine botox treatment can be prescribed by a neurologist can (at a subsidised cost) if:

• a patient has chronic migraine AND
• has failed to improve with three oral preventative medicines or could not tolerate them

You can speak with an InstantScripts GP for more information about these treatments, or for a specialist referral.

Find out the latest in migraine news in Australia

To find out the latest in migraine news, tune into Migraine & Headache Awareness Week (September 20 – 24).

• Live webinars with chronic migraine specialists
• Live panels with patients
• Information, resources and articles

Get the information you need to gain more control over your health.