13th August 2024

A 26-year-old female has been suffering from migraines for the last 6 years

A 26-year-old female has been suffering from migraines for the last 6 years. She experiences severe symptoms on at least 10 days per month and is not able to work on these days in her job as a retail assistant. She has heard about a medication called topiramate which can reduce the frequency of migraines and she would like to try it. On assessment, her BP is 121/62 and HR 88. She has a past medical history of a pulmonary embolism during her recent pregnancy and an appendectomy 13 years ago. She lives with her partner and 1 year-old daughter. She is currently taking the progesterone only contraceptive pill, however she reports she will be stopping this in 6 months in order to try and have a second child.

What is the most appropriate preventative management of her migraines?

Select the SINGLE most appropriate option from the list below. Select ONE option only.