Table 1 Initiation strategy from Medical Advisory Board

•

Initiate treatment as early as possible when patient first experiences symptoms of migraine, including pain and/or aura symptoms.

•

Fill-out the headache diary immediately after treatment or at any time after the migraine attack subsides.

•

Record all symptoms, triggers and medications used during each attack in a diary

•

Increase the number of pulses delivered during an attack using the following systematic method as needed to improve pain and symptom relief.

•

Encourage the patient to deliver 2 sequential pulses as early as possible at the beginning of the migraine attack.

•

Continue with 2 pulses every 15 min for 1–2 h or until pain and symptoms resolve.

•

Encourage patients to withhold using rescue medication for the first hour or two if possible.

•

Encourage the patient to deliver 3 sequential pulses as early as possible at the beginning of the migraine attack.

•

Continue with 3 pulses every 15 min for 1–2 h or until pain and symptoms resolve.

•

Encourage the patient to deliver 4 sequential pulses as early as possible at the beginning of the migraine attack.

•

Continue with 4 pulses every 15 min for 1–2 h or until pain and symptoms resolve.