Headaches: Nonsurgical Management

Aetna covers IV dihydroergotamine (DHE) only for status migrainosus (>72 hours), other intractable severe migraines unresponsive to analgesics and triptans, cluster headaches refractory to oxygen or triptans, and inpatient treatment of medication‑overuse headache, and requires administration in the emergency room, urgent care, or hospital setting. IV DHE for other headache types or for intermittent migraine without an active, prolonged (>72‑hour) debilitating attack at admission is considered experimental/investigational, as are numerous other nonsurgical interventions (e.g., IV ketamine, IV lidocaine, IV valproate, nerve blocks, neuromodulation devices, intranasal DHE, etc.).

"Magnesium supplementation for migraine prevention in adults (limited evidence from small RCTs with mixed results; discussed as a possible option)."

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