<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden. The present study aimed to individualize the treatment protocols for episodic and chronic migraine in order to reduce the duration, frequency, and severity of attacks, as well as the disability associated with migraine by comparing monotherapy and dual therapy.</p>
</sec>
<sec><h3>Materials and Methods</h3>
<p>We conducted a prospective observational study between February 2019 and July 2021. Patients were diagnosed with migraine based on simplified diagnostic criteria. Episodic migraine was present in 62% and chronic migraine in 38% of cases. Disability due to headache was assessed using the Migraine Disability Assessment Score (MIDAS) questionnaire. Prophylactic therapy was individualized, with 210 patients receiving monotherapy (propranolol, flunarizine, or valproic acid) and 190 patients receiving dual therapy (propranolol and flunarizine, or valproic acid and flunarizine). Disability at baseline was graded from I to IV, and improvement after treatment was graded as no recurrence of headache, grade I, grade II, and grade III.</p>
</sec>
<sec><h3>Results</h3>
<p>After 2–3 months of therapy, we observed significant improvement in the form of reduction in the frequency of attacks and reduction of disability. Patients with grade II disability who received dual therapy showed 100% improvement with no recurrence of headaches. Treatment with valproic acid resulted in no recurrence in 100% of patients with grade I and 85.7% of patients with grade II disability scores. Significant improvement was observed in all grades of disability with dual therapy.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Dual prophylactic therapy was more efficient than monotherapy in reducing the frequency, duration, and severity of symptoms in grade III and grade IV patients.</p>
</sec>
</abstract>

Background
Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden. The present study aimed to individualize the treatment protocols for episodic and chronic migraine in order to reduce the duration, frequency, and severity of attacks, as well as the disability associated with migraine by comparing monotherapy and dual therapy.

Materials and Methods
We conducted a prospective observational study between February 2019 and July 2021. Patients were diagnosed with migraine based on simplified diagnostic criteria. Episodic migraine was present in 62% and chronic migraine in 38% of cases. Disability due to headache was assessed using the Migraine Disability Assessment Score (MIDAS) questionnaire. Prophylactic therapy was individualized, with 210 patients receiving monotherapy (propranolol, flunarizine, or valproic acid) and 190 patients receiving dual therapy (propranolol and flunarizine, or valproic acid and flunarizine). Disability at baseline was graded from I to IV, and improvement after treatment was graded as no recurrence of headache, grade I, grade II, and grade III.

Results
After 2–3 months of therapy, we observed significant improvement in the form of reduction in the frequency of attacks and reduction of disability. Patients with grade II disability who received dual therapy showed 100% improvement with no recurrence of headaches. Treatment with valproic acid resulted in no recurrence in 100% of patients with grade I and 85.7% of patients with grade II disability scores. Significant improvement was observed in all grades of disability with dual therapy.

Conclusion
Dual prophylactic therapy was more efficient than monotherapy in reducing the frequency, duration, and severity of symptoms in grade III and grade IV patients.

Dual versus Monotherapy in the Prophylaxis of Acute and Chronic Migraine

Department of Radiological Physics and Bio-Engineering

Department of Pharmacology Government Medical College Srinagar

Journal of Interdisciplinary Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Dual versus Monotherapy in the Prophylaxis of Acute and Chronic Migraine"}

Background
Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden....

Dual versus Monotherapy in the Prophylaxis of Acute and Chronic Migraine

Published Online: Sep 21, 2023

Page range: 6 - 10

Received: Jan 09, 2023

Accepted: Mar 20, 2023

DOI: https://doi.org/10.2478/jim-2023-0002

Keywords
Migraine Disability Assessment (MIDAS) score, monotherapy, dual therapy

© 2023 Muddasir Sharief Banday et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Dual versus Monotherapy in the Prophylaxis of Acute and Chronic Migraine

Published Online: Sep 21, 2023

Page range: 6 - 10

Received: Jan 09, 2023

Accepted: Mar 20, 2023

DOI: https://doi.org/10.2478/jim-2023-0002

KeywordsMigraine Disability Assessment (MIDAS) score, monotherapy, dual therapy

© 2023 Muddasir Sharief Banday et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Migraine Disability Assessment (MIDAS) score, monotherapy, dual therapy