{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:20:37Z","timestamp":1790713237949,"version":"4.1.0"},"reference-count":9,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The small molecule calcitonin gene\u2013related peptide receptor antagonists (gepants) are the only drug class with medicines indicated for both the acute and preventive treatment of migraine. Given this dual capacity to both treat and prevent, along with their favorable tolerability profiles and lack of an association with medication\u2010overuse headache, headache specialists have begun to use gepants in ways that transcend the traditional categories of acute and preventive treatment. One approach, called\n                    <jats:italic>situational prevention<\/jats:italic>\n                    , directs patients to treat during the interictal phase, before symptoms develop, in\u00a0situations of increased risk for migraine attacks. Herein, we present three patients to illustrate scenarios of gepant use for situational prevention. In each case, a gepant was started in anticipation of a period of increased headache probability (vulnerability) and continued for a duration of 1\u2009day to 5 consecutive days. Although this approach may expose patients to medication when headache may not have developed, the tolerability and safety profile and preventive effect of gepants may represent a feasible approach for some patients. Situational prevention is an emerging strategy for managing migraine before symptoms develop in individuals who can identify periods when the probability of headache is high. This paper is intended to increase awareness of this strategy and stimulate future randomized, placebo\u2010controlled trials to rigorously assess this strategy.\n                  <\/jats:p>","DOI":"10.1111\/head.14775","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T04:59:42Z","timestamp":1719982782000},"page":"859-864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Situational prevention: Pharmacotherapy during periods of increased risk for migraine attacks"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2652-2897","authenticated-orcid":false,"given":"Richard B.","family":"Lipton","sequence":"first","affiliation":[{"name":"Department of Neurology Albert Einstein College of Medicine  Bronx New\u00a0York USA"},{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine  Bronx New York USA"},{"name":"Department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ailani","sequence":"additional","affiliation":[{"name":"Department of Neurology Medstar Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7076-3497","authenticated-orcid":false,"given":"Kathleen","family":"Mullin","sequence":"additional","affiliation":[{"name":"The New England Institute for Neurology and Headache  Stamford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena M.","family":"Pavlovic","sequence":"additional","affiliation":[{"name":"Department of Neurology Albert Einstein College of Medicine  Bronx New\u00a0York USA"},{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine  Bronx New York USA"},{"name":"Department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart J.","family":"Tepper","sequence":"additional","affiliation":[{"name":"The New England Institute for Neurology and Headache  Stamford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Dodick","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Scottsdale Arizona USA"},{"name":"Atria Academy of Science and Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Blumenfeld","sequence":"additional","affiliation":[{"name":"The Los Angeles Headache Center  Los\u00a0Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/S1474-4422(21)00409-9","article-title":"Calcitonin gene\u2010related peptide\u2010targeting drugs for migraine: how pharmacology might inform treatment decisions","volume":"21","author":"Al\u2010Hassany L","year":"2022","journal-title":"Lancet Neurol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2147\/DHPS.S304373","article-title":"Safety and risk of medication overuse headache in lasmiditan and second\u2010generation gepants: a rapid review","volume":"13","author":"Lo Castro F","year":"2021","journal-title":"Drug Healthc Patient Saf"},{"issue":"10419","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1016\/S0140-6736(23)01683-5","article-title":"Ubrogepant for the treatment of migraine attacks during the prodrome: a phase 3, multicentre, randomised, double\u2010blind, placebo\u2010controlled, crossover trial in the USA","volume":"402","author":"Dodick DW","year":"2023","journal-title":"Lancet"},{"issue":"4","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/head.14479","article-title":"Expert consensus established around flexible, individualized migraine treatment utilizing a modified Delphi panel","volume":"63","author":"Graf M","year":"2023","journal-title":"Headache"},{"issue":"2","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1468-2982.2008.01690.x","article-title":"Applying the benefits of the AwM study in the clinic","volume":"28","author":"Dodick DW","year":"2008","journal-title":"Cephalalgia"},{"issue":"17","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"e1905","DOI":"10.1212\/WNL.0000000000201031","article-title":"Efficacy of ubrogepant in the acute treatment of migraine with mild pain vs moderate or severe pain","volume":"99","author":"Lipton RB","year":"2022","journal-title":"Neurology"},{"issue":"17","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000202043","article-title":"Ubrogepant for the acute treatment of migraine when administered during the prodrome (premonitory phase): results from a phase 3, randomized, double\u2010blind, placebo\u2010controlled, crossover study (S47.001)","volume":"100","author":"Dodick D","year":"2023","journal-title":"Neurology"},{"issue":"12","key":"e_1_2_8_9_1","first-page":"S50","article-title":"Clinical trials of acute treatments for migraine including multiple attack studies of pain, disability, and health\u2010related quality of life","volume":"65","author":"Lipton RB","year":"2005","journal-title":"Neurology"},{"issue":"8","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1111\/head.14182","article-title":"Continuous updating of individual headache forecasting models using Bayesian methods","volume":"61","author":"Houle TT","year":"2021","journal-title":"Headache"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:39:41Z","timestamp":1767613181000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/head.14775"],"URL":"https:\/\/doi.org\/10.1111\/head.14775","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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