A 19-year-old woman was diagnosed with migraine headaches 2 years ago. Her headaches had previously responded to early use of a nonsteroidal anti-inflammatory drug (NSAID) and rest. However, that treatment had become less effective and she was given a triptan prescription as a therapeutic trial.

She has come to your clinic because she says her pain did not get better when she used that triptan for 2 recent migraine headaches.