AHS 2023 | Defining refractory migraines

Morris Levin, MD, University of California San Francisco, San Francisco, CA, discusses the definition and classification of refractory migraines. The term ‘refractory’ emerged to describe patients with migraine who do not get better, even after all typical interventions and lifestyle modifications. Treating these people as a distinct group would allow us to better study and devise treatment for these individuals. There are multiple definitions for ‘refractory migraine’, each of which mandates that the patient must not have responded to a specific number of medications. The AHS special interest group for refractory migraines is currently part of an ongoing effort to gain funding for research to validate a definition of ‘refractory migraine’. Other controversies surrounding refractory migraine include whether medication-overused headache or disability are included and whether we focus on the frequency of headache or failure to respond to medication. In the case of the latter, the question of which medications we focus on remains. This interview took place at the American Headache Society 2023 meeting in Austin, TX.

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