Is Single-Drug Prophylaxis in Migraine Prevention a Better Option than Combination Therapy? An Observational Study in a Rural Tertiary Care Center in North West India

Background  Migraine is a primary headache disorder that has a great impact on quality of life of patients. Pharmacologic therapy may be given in acute or abortive form and in the form of preventive therapy. In what form is preventive therapy to be given? Whether monotherapy is to be used or combination therapy? In what cases does combination therapy fare better than monotherapy? These queries are still unanswered. Materials and Methods  All patients with headache reporting to the outpatient department were screened, and those fulfilling inclusion criteria were included in the study. Those patients who had chronic daily headache (headache for 15 or more days in a month) or who had other comorbidities and those who were taking any other drugs and were pregnant were excluded from the study. Baseline parameters, duration of headache, frequency of attacks, severity, and location of headache, triggers, and aggravating factors were recorded. Then, patients were started on abortive and preventive therapy. The follow-up was done at 3 and 6 months and if required earlier. At each follow-up, data regarding frequency, severity, and adverse effects were recorded and analyzed. Results  We studied 105 patients of migraine, out of which 15 (14.3%) were males and 90 (85.7%) were females. Moreover, most (72%) of the patients were of the age group of 30 to 49 years. Only 11 (10.5%) patients required three or more preventive medicines for the control of headache and rest 94 (89.5%) patients were controlled on single (49 patients, i.e., 46.7%) or two 45, that is, 42.9% preventive medicines 49. Conclusion  For the newly diagnosed migraine cases, the single-drug preventive therapy is more useful than the combination of drugs.