Headache diary to track triggers and frequency

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Comprehensive Evaluation: Headache diary to track triggers, frequency, severity, and medication use Rule out medication-overuse headache Screen for generalized anxiety disorder (GAD-7) and depression (PHQ-9) Preventive Migraine Therapy: Since she's having >4 migraines/month, initiate preventive therapy: First-line: Beta-blockers (e.g., propranolol) or tricyclic antidepressants (e.g., amitriptyline) Alternatives: Topiramate, valproic acid, or CGRP inhibitors (e.g., erenumab) - with caution in women of childbearing age Acute Treatment Options: Consider triptans (e.g., sumatriptan) for abortive therapy, if not contraindicated Avoid NSAID overuse to prevent rebound headaches Anxiety Management: Consider SSRI or SNRI for anxiety (e.g., sertraline, venlafaxine) Behavioral therapies: CBT, relaxation techniques, biofeedback Address anticipatory anxiety around migraines.

Reference no: EM133879452

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