Managing Chronic Migraine Through Treatment and Lifestyle Decisions: Dolores Santamaria, MD

WATCH TIME: 4 minutes

"It’s really important to understand the multidisciplinary approach. It’s not just one shot, come take a pill and go. You have to assess the patient and the different directions. That’s why I always work with a lot of holistic approaches, using a lot of vitamins, etc."

Chronic migraine is defined as having at least 15 headache days a month, with at least 8 days of having headaches with migraine features, for more than 3 months. This type of migraine begins with less frequent headache episodes that gradually change into a more frequent pattern over time. Approximately 3% to 5% of people in the US have chronic migraine, and approximately 3% of those with episodic migraine transform to chronic migraine each year.

Aside from the number of episodic headaches, there can be several factors that cause chronic migraine, including overusing medications designed to treat episodic migraines, obesity, snoring, mood disorders, ongoing disrupted sleep pattern, excessive caffeine intake, and history of emotional or physical trauma. There are several preventive treatments aimed at reducing the number of headaches, including beta blockers, angiotensin blockers, tricyclic antidepressants, anticonvulsants, onabotulinumtoxinA (Botox), and calcitonin gene-related peptides (CGRPs). In addition to medications, a lot of treating chronic migraine is focused on managing lifestyle choices and headache triggers.

Dolores Santamaria, MD, director of the Headache Center at Allegheny Health Network, believes that treating patients with chronic migraine requires a thorough, multidisciplinary approach. In an interview with NeurologyLive^®, Santamaria discussed the balance of treatment vs lifestyle decisions, and whether clinicians tend to harp on one or another for best management of chronic migraine.