NINDS CRC Chronic Migraine Treatment Trial

Exclusion Criteria

• •Prior neuro-imaging suggesting secondary structural causes of headache
• •Beck Depression Inventory FastScreen score of 13 or greater or other severe psychiatric disorder
• •Contraindication to or prior intolerance of topiramate or propranolol (no history of sinus bradycardia, heart block, heart failure, diabetes prone to hypoglycemia, asthma, kidney stones)
• •History of kidney failure or nephrolithiasis
• •A female who is currently pregnant or lactating or planning to become pregnant in the next year, or is of child-bearing potential and not practicing an acceptable form of birth control
• •Currently requires butalbital or opioid drugs for acute headache treatment 10 or more days a month
• •Failure of prior trials with at least 50 mg of topiramate combined with at least 80 mg of propranolol
• •Use of other migraine preventive drugs (Medications graded as groups 1, 2, 3, and 4 in the AAN Evidence-based Guideline: valproate, divalproex sodium, gabapentin, amitriptyline, nortriptyline, protriptyline, beta-blocker, calcium channel blocker, cyproheptadine; and tizanidine) within the last two months or has received botulinum toxin injection in the past 3 months