When do you consider IV ketamine for status migrainosus?

Given that the current evidence for IV ketamine is of low quality and primarily limited to retrospective studies - with the American Headache Society 2025 ED guidelines assigning it a level U (no recommendation) - I would consider it in the inpatient setting only after standard abortive therapies ha...

I would not consider IV ketamine for status migrainosus, as I like to keep patients out of the emergency room. My treatment of migraine status is with a three-day course of a combination of prednisone and diazepam. I prescribe the prednisone in a dose of 15 mg qid x 1 day, 10 mg qid x 1 day, and 5 m...