Scenario 5 A 46-year-old female presents for management of a 25-year history of migraine (with or without aura). Over the past 5 years her migraines, which she manages with triptans (daily), have become chronic. She has a history of depression and sleep disturbance. The patient has previous trialled and failed to respond to, had insufficient response to, or experienced intolerable side effects with multiple prophylactic therapies including onabotulinum toxin A, topiramate, verapamil, propranolol, and amitriptyline. How should the clinician treat this patient?