What outpatient therapies do you recommend for continuous or severe pain from migraine that is refractory to acute therapies?

I assume that what we are dealing with here is what we call a migraine status or status migrainosus. This refers to a migraine headache that has continued well beyond its usual duration, for which we often use the arbitrary three-day mark. We base this mark on the erroneous assumption that migraine ...

I agree with Dr. @Dr. First Last that the two best medications to stop status migrainosus or any long-duration migraine are dihydroergotamine (DHE) and corticosteroids.

It is ideal when the patient can give themselves a subcutaneous injection of DHE at home, but this is difficult to arrange and for ...

Once status migrainosus (a migraine attack lasting more than 72 hours) sets in, oral acute medications usually do not work. While some people have effectively used a neuromodulation device (Nerivio), studies included patients with headaches lasting <72 hours, so its efficacy for status migrainosus r...