NINDS CRC Chronic Migraine Treatment Trial

Inclusion Criteria:

• History of chronic migraine for at least 6 months

• Age ≥ 18 years and age of migraine onset 60 or younger

• EKG performed in the last 12 months

Exclusion Criteria:

• Prior neuro-imaging suggesting secondary structural causes of headache

• Beck Depression Inventory FastScreen score of 13 or greater or other severepsychiatric disorder

• Contraindication to or prior intolerance of topiramate or propranolol (no history ofsinus 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 thenext year, or is of child-bearing potential and not practicing an acceptable form ofbirth control

• Currently requires butalbital or opioid drugs for acute headache treatment 10 or moredays a month

• Failure of prior trials with at least 50 mg of topiramate combined with at least 80 mgof propranolol

• Use of other migraine preventive drugs (Medications graded as groups 1, 2, 3, and 4 inthe 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 botulinumtoxin injection in the past 3 months