Comparative Effectiveness of Migraine Preventive Medications: The APT Comparison Study

Inclusion Criteria

• •Adults, 18-70 years of age at the time of enrollment
• •Migraine with aura, migraine without aura, and/or chronic migraine; according to ICHD-3 diagnostic criteria. (Those with daily or continuous headaches are not excluded.)
• •Migraine onset prior to 50 years of age
• •Migraine present for at least 12 months at the time of enrollment
• •At least four "moderate to severe headache days" per month (by patient self-report and then confirmed during four-week pre-randomization headache diary phase) A "moderate to severe headache day" is defined as a day during which there is a headache of moderate to severe intensity that lasts for at least four hours, or a day on which a migraine-specific acute medication is taken to treat headache.
• •If already taking a migraine preventive treatment, willing to continue with that treatment without dose change during the first 16 weeks of the study, including the 4-week run-in phase and 12-week randomized phase.
• •Not pregnant or breastfeeding
• •Women of childbearing potential must agree to use effective methods of contraception to reduce the risk of pregnancy.
• •Willingness and ability to provide informed consent.
• •Willingness and ability to complete all research visits.