Headache preventative therapy should be considered if headaches are > 1 attack per week, if headaches are severe or disabling that results in absence of work, school and social activities or if one is unable to take acute medications to treat their headache.

Although migraine is considered a life-long condition, for majority of patients, preventative agents are not necessarily used life-long. Typically after 6-12 months of successful treatment, one could slowly taper and discontinue the preventative medication. If migraines come back, then the drug is still justified and may be continued.

Migraine is a neurological disorder that may justify the use of long-term medication, just like any other chronic disease. Readjusting your expectations can be very positive over time. No migraines and no drug is not always possible. The ultimate goal is to reach a good quality of life and decrease migraine frequency.