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If attacks are severe enough to require hospitalization or cause substantial absenteeism from school or work [21] Prophylactic medications include: Amitriptyline First line 75-100mg per day More effective in those with family history of migraines Anticonvulsants (topiramate, zonisamide, levetiracetam) Second line Topiramate (100mg), zonisamide (400mg), levetiracetam (1000mg) Mitochondrial supplementation Adjunctive therapy Very limited evidence Coenzyme Q10 (200mg BID), Riboflavin (200mg BID) [15]

PMID: 27633659

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Concurrent metformin use is well represented in diabetes trials, which often added tirzepatide on top of metformin

Pennsylvania Student Sustainability Symposium Location: Dickinson Gibson Finch Holland Dickinson Idea Fund Date: March 21, 2014 Event: 2014 Pennsylvania Environmental Resource Consortium