title: Clinical considerations on chronic migraine, pharmacoresistance and refractoriness.
abstract: Patients with chronic migraine are difficult to treat and often analgesic overusers. In this article attention is focused on aspects considered important for producing a definition of refractory in relation to this headache form. I propose that a "chronic migraine" patient should be considered "refractory" to pharmacological prophylaxis when adequate trials of preventive therapies at adequate doses have failed to reduce headache frequency and improve headache-related disability and, in patients with medication overuse, also failed to reduce the consumption of symptomatic drugs.
authors.affiliation: Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria 11, 20133, Milan, Italy. bussone@istituto-besta.it
authors.forename: Gennaro
authors.initials: G
authors.lastname: Bussone
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease / Q000188:drug therapy; D051271:Headache Disorders, Secondary / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008881:Migraine Disorders / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000700:Analgesics