Correct Answer: B. New guidelines from the International Headache Society suggest assessing the initial effectiveness of a preventive migraine medication after a trial of at least 3 months at an effective dose (or 6 months for agents given quarterly). In addition, we delay discussing an attempt to wean therapy until symptoms are well controlled for at least 6 to 12 months. However, the decision to attempt to taper preventive therapy to assess for spontaneous symptom remission should be individualized based on pretreatment symptom burden, the presence of medication adverse effects, and patient preferences. 
 

As you can see from the results above, it's a challenge to always identify the correct diagnosis. 
 

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