There are over 150 different types of migraines, distinguished by their specific symptoms as well as their frequency and onset. For someone to be diagnosed with a migraine, the NIH notes that they must have at least five episodes of a pulsing or throbbing pain in their head that lasts 4-72 hours without treatment. Migraines tend to come with nausea and sensitivity to light or sound.

Chronic migraine is a particularly aggressive form of migraine, where you have at least three months and at least half of your month is spent with a migraine headache. Experts at institutions like the Cleveland Clinic note that chronic migraine sufferers usually start out with less frequent headaches that become more frequent—and intense—over time.

Obesity, poor sleep, anxiety, trauma, and excessive caffeine use can all predispose someone to chronic migraines. But one key contributing factor to chronic migraine headaches that has only recently been gaining recognition is medication overuse. From over-the-counter non-steroidal anti-inflammatory medications (nSAIDs) through barbiturate-containing prescription medications, medication overuse can actually make migraines worse.

Because of the role treatment medication might play in perpetuating the migraine cycle, researchers are looking beyond simply treating symptoms, and trying to find a way to help prevent migraines in the first place. This is also an attractive option for people who are trying to avoid taking excess medications, or who face major side effects from their migraine medication.

And, if you suffer from chronic migraines, you know how difficult it can be to work or maintain close personal relationships. Chronic migraine prevention could allow you to live a normal life.

One of the first steps in trying to manage migraines is identifying whether anything specific triggers your migraine headaches. From certain foods through particular types of stress, there may be ways to adjust your lifestyle to avoid things that tend to exacerbate your headaches.

Your doctor may recommend you try medicine to prevent migraines. People often try these medicines first to see if they work in preventing migraines, and then to evaluate whether they can tolerate any side effects associated with the medication.

– Topiramate is often one of the first medications tested for migraine prevention, or “prophylaxis.” Topiramate is an anti-seizure medication, or anticonvulsant, which has been shown to reduce migraine frequency, although it often leaves people feeling sleepy.

– Metoprolol and other beta blockers are often the next drug that chronic migraine sufferers are prescribed to try and prevent migraines. Beta blockers help reduce blood pressure, however people may feel depressed or experience sexual dysfunction. Similarly, calcium-channel blockers like diltiazem or verapramil may also be tried. These drugs also work through reducing blood pressure.

– In some people, antidepressants like selective serotonin reuptake inhibitors have been shown to help with migraine prevention.

– A newer player on the migraine prophylaxis scene is the cGRP inhibitor, which blocks the effects of cGRP—the molecule associated with migraine pain. Aimovig, Ajovy, and Emgality are some examples of this newer medication type. Unlike the previous medicines which are taken in a pill form, cGRP inhibitors are administered through a monthly EpiPen-like injection.

– Similarly, Botox (or botulinum toxin) might be another option for chronic migraine sufferers. Several injections on the face and in the scalp are administered about every three months.

If you are a chronic migraine sufferer who has not found relief for your symptoms with these options, you are likely hoping that researchers find a new prevention method. Your participation in a clinical trial might help uncover a new option for chronic migraine prevention.

If you are suffering from chronic migraines, the first step is to connect with your physician. Your doctor and their team can support you from migraine diagnosis through treatment.

There are several potential benefits to diligently monitoring your chronic migraine headaches. Keeping track of symptoms and circumstances might help you identify potential triggers more easily, which may help you manage or even prevent headaches. You can also get a sense of whether your migraines are occurring more often or more intensely, or if you’re trending towards relief. Consider downloading a migraine headache monitoring app to help you keep track. There are several potential benefits to diligently monitoring your chronic migraine headaches. Migraine Buddy and Migraine Insight App are among the most-downloaded migraine headache monitoring apps.

Chronic migraines can interfere with work and school. If migraines are interfering with your job, you can consider filing for disability. A starting place for information on migraine as a disability and how to proceed in receiving support and benefits would be Migraine Australia or the Australian Federation of Disability Organisations | Australian Federation of Disability Organisations (afdo.org.au).

Living with chronic migraines might make it difficult to show up for work or personal life, but you don’t have to suffer in complete isolation. In between episodes, connect with everything from support groups through public policy advocacy groups. Online forums feature opportunities to connect with others or read content produced by some of the world’s leading migraine specialists. Support Group – Headache Australia and Support Groups – Migraine Australia are two good resources.

Treatment for migraine medication can get expensive, but there may be options available to help pay for medical care and prescriptions. The Australian government plan for people with a Medicare card, Pharmaceutical Benefits Scheme – Services Australia, subsidizes the cost of medicine for most medical conditions.

Talk to your doctor about whether you might want to volunteer in clinical research. Your participation could help find new or improved treatment options.