Mount Carmel Health Partners Clinical Guidelines Migraine | Page 3

Prophylactic Treatment for Migraine Headache
Patient meets criteria for
prophylaxis (see
prevention section)
Evaluation
Treatment
Assess factors that may trigger
migraines (see Table D) and
encourage non-pharmacologic
therapies (see Table E).
Yes
Is migraine
frequency/intensity
cut in half after 3 to
6 months?
No
Initiate mono
prophylactic treatment
with titration
(see Table F).
Is migraine
frequency/intensity
cut in half after 3 to
6 months?
No
Initiate alternate
mono prophylactic
drug therapy
(see Table F).
Yes
Yes
Follow-up and
monitor annually.
Is migraine
frequency/intensity
cut in half after 3 to
6 months?
Yes
No
Initiate combination
therapy (see Table F)
Is migraine
frequency/intensity
cut in half after 3 to
6 months?
No
Refer patient to a
qualified specialist.
Migraine - 3