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Methods AMPP study surveys were mailed to a sample of 24,000 persons with “severe headache” identified in 2004 and followed annually through 2009. Eligible subjects had ICHD-2 migraine, reported triptan use one year and medication data in the subsequent year (a couplet). We examined 4 patterns: a) consistent triptan use, b) switching to another triptan, c) switching to an opioid/barbiturate, or d) switching to a NSAID. Change in disability was measured with MIDAS change from the second to the first year (negative change scores reflect reduction in disability). Change scores were modeled via ANOVA for couplets by 3 strata of average headache days: low (0-4 days/month), moderate (5-9 days/month), and high frequency episodic/ chronic migraine ([HFEM/CM]≥10 days/month). ANOVAs were estimated for each switch pattern relative to the consistent triptan use group. The values of (b) represent change in MIDAS score.

Consistency vs. switching triptan treatment and headache-related disability: Results of the American migraine prevalence & prevention study