In part one of Dr Kernick’s blog, he outlined six initial expectations for GP visits for migraine, including being offered an appropriate treatment and being taken seriously.

In part two, Dr Kernick talks us through more of what you can expect during a GP appointment, as well as what you can do to get the most out of your appointment time.

You should expect:

7) To be offered preventive medication if needed.

Whether you are offered a preventive medicine will depend on several factors, including how many migraine attacks you are getting, whether painkillers and triptans have helped, and the impact migraine is having on your life. It depends on how you feel about taking regular medication too. If you have tried three preventive medications and these haven’t helped, you should be offered one of a recently introduced group of drugs known as CGRP antagonists. These include self-injectable CGRP monoclonal antibodies and oral gepants. In many areas gepants can be prescribed by GPs but many NHS areas require referral to neurology. This is likely to change with time.

How to get the most out of your GP appointment: Ensure you have followed your GP’s guidance on taking the medication at the recommended dosage for at least eight weeks before you judge effect of benefit.

Note – guidelines on which preventives to use can vary locally. You can read more about approvals in different areas of the UK on our treatment information pages.

8) To discuss whether you are planning a pregnancy.

Some drugs should be avoided or used with caution in pregnancy.

How to get the most out of your GP appointment: Tell them if you are currently planning a pregnancy or breastfeeding.

9) To explore other relevant conditions.

Several other conditions are commonly associated with migraine, particularly chronic migraine. These include anxiety, depression, fibromyalgia, irritable bowel syndrome, insomnia and restless legs syndrome.

How to get the most out of your GP appointment: It is unlikely that your GP will be able to fully explore associated conditions in the first consultation. It may be worth mentioning any other conditions that you think may be associated with migraine and ask if that could be dealt with at a subsequent appointment. Migraine and mental health can be closely linked. If you’re struggling to cope it’s important to speak to your GP, and any other doctors involved in your care, so they are aware of this. You can be referred to other services locally that may be able to offer support, such as talking therapy.

10) Not to expect further investigation such as scans or testing unless certain ‘red flag’ symptoms are noted.

Most people with migraine won’t need further investigations to make a diagnosis. Your doctor may recommend a brain scan or further investigations only in certain circumstances.

How to get the most out of your GP appointment: Tell them if you have a particular anxiety about anything serious which can be explored.

11) To be referred if things are not moving forward.

Ideally to a practitioner with an interest in headache. The Migraine Trust has a list of headache clinics.

12) To be signposted to migraine resources.

The Migraine Trust offers support and further information.

The National Migraine Centre also has an excellent and comprehensive series of podcasts.

Don’t forget, a 10-minute consultation can go very quickly, and it can be hard to discuss everything in that time. The most important thing is to explain how much your symptoms are impacting you, and to work with your doctor on the best way to manage your migraine going forwards.