19th June 2023

A 23-year-old woman presents with a unilateral headache associated with nausea and increased sensitivity to noise

A 23-year-old woman presents with a unilateral headache associated with nausea and increased sensitivity to noise. She had been investigated a year ago for a similar episode with a CT head scan and lumbar puncture, which were normal. She has been having episodic headaches since, which subside with analgesics. However, her pain has increased in frequency, and it is starting to affect her quality of life. She is known to have an allergy to amoxicillin and does not have any regular medications. She is a non-smoker, works as a nurse and lives with her partner.

Which one of the following pharmacology treatments is most appropriate to aim to reduce the frequency of her headaches?