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Important Treatment Data in Chronic Migraine
Hans-Christoph Diener, MD, PhD
Medscape Neurology
July 26, 2013

Chronic migraine is defined as headaches occurring on more than15 days per month, with at least 8 days to fulfill the criteria of migraine without aura. This condition is very difficult to treat. There are only 2 effective and approved treatments: topiramate and botulinum toxin.

A considerably large subgroup of patients with chronic migraine overuses medication. A subgroup analysis of the large-scale clinical trials that led to the approval of botulinum toxin (a predefined substudy) was published recently,[1] looking at patients from the PREEMPT trial who had medication overuse. We have to carefully differentiate between "medication overuse" (which is intake of a triptan on more than 10 days per month, or analgesics on more than 15 days per month) and "medication overuse headache."
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