Drug therapy of migraine

To the Editor: We were surprised to see no mention of corticosteroids in Dr. Welch's otherwise informative survey of current migraine therapy (Nov. 11 issue)¹. Corticosteroids have been recommended for the treatment of prolonged migraine²,³ and are commonly prescribed for that indication in the community at large. A survey of the members of the American Association for the Study of Headache found that 20 percent of responding physicians used corticosteroids as first-line agents in patients with prolonged migraine and 19 percent used them as second-line therapy⁴. Although, as noted by Dr. Welch and his colleagues,⁵ the efficacy.