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IHC 2023 | Migraine prophylaxis: low budget solutions

Prescribing CGRP antagonists for migraine prophylaxis has become popular in some countries, but these drugs are not widely accessible worldwide. Mansoureh Togha, MD, Tehran University of Medical Sciences, Tehran, Iran, explores alternative low-cost drugs available in different regions. The literature review revealed that topiramate and botulinum toxin are comparable to CGRP antagonists in terms of efficacy. However, topiramate may have side effects such as difficulty in word-finding or decreased concentration, leading some patients to discontinue its use. On the other hand, botulinum toxin and CGRP antagonists have better patient adherence, although their efficacy is similar. Overall, data suggests that while other drugs can work for migraine prevention, if CGRP antagonists are available, they might be a better option due to improved patient adherence. This interview took place at the International Headache Congress (IHC) 2023 in Seoul, Korea.

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