A 28-year-old female experiences 6-8 debilitating migraine headaches per month, each lasting 2-3 days, significantly impairing her work and social life. She has tried ibuprofen and sumatriptan for acute attacks with some success but wants to reduce frequency. What is the most appropriate pharmacologic intervention for migraine prophylaxis?
✓ Correct Answer: Option C
For patients with frequent or debilitating migraines (generally >4 per month or significantly impacting quality of life), prophylactic therapy is indicated. Topiramate, propranolol, amitriptyline, and valproate are first-line prophylactic agents. Sumatriptan is for acute treatment, not prophylaxis.