Failures in Migraine Therapy

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Abstract
Of 800 patients treated at the Montefiore Hospital Headache Clinic, all had the usual features of the migraine syndrome and were followed 1-4 yrs. It would appear that the most common causes of therapeutic failure are: incorrect diagnosis; inappropriate, inadequate or improper admn. of medication; inflexibility of therapeutic regime; failure to recognize the variable etiology of the syndrome; additional factors associated with the attack; and finally the vital role of the patient-physician relationship. These observations have suggested to the authors that symptomatic therapy in migraine must be flexible and individual; variable, accessory and complicating factors must be considered in each case; more intensive psychotherapy is indicated in both refractory and response cases.

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