Delussi M, Vecchio E, , et al. - This study was sought to assess the short-term impact of preventive treatment in a cohort of migraine patients attending a tertiary headache center, using data from electronic medical records. Researchers performed an observational retrospective cohort study to collect data from a tertiary headache center between January 2009 and December 2019. The primary endpoint included the change in the frequency of headache at the follow-up visit. They applied disability scores, the intensity of headache, and allodynia as secondary outcome measures. In this analysis, 2800 met the selection criteria, 1800 returned to the follow-up visit, 550 withdrew because of adverse events, and 1100 were enrolled, among the 6430 screened patients. The results of this study demonstrate that the mild impact of preventive drugs on migraine features and even the number of patients who were lost to follow-up or dropped out because of adverse events confirm that in severe and chronic patients, the first line of prevention can only delay a more targeted therapeutic approach.