Miss Thompson is a 27 year old female who has come to see you as she has developed recurrent debilitating headaches. She has had four episodes in the last four months. During each of the most recent episodes, she notices her sense of smell is heightened and she feels nauseous but has not vomited. At its peak the headache is 9/10 in severity, most severe over her left temple and she must stay in bed until it subsides. The duration varies from 24 – 36hours. The pain is described as throbbing in nature.

Miss Thompson suffers with Irritable Bowel Syndrome, Eczema, Asthma and mild anxiety. Current medication includes: Diprobase cream, Salbutamol inhaler and Cerazette. She works fulltime as a primary school teacher, smokes two cigarettes a day and drinks seven units of alcohol a week. Miss Thompson would like some medication that she can take when the headaches occur.

Given her likely diagnosis, which is the most suitable treatment to offer?

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