You are assessing a 27-year-old female who has trouble with migraines. She has daily headaches and is known to overuse pain medications. She currently uses ibuprofen and if that doesn’t work she uses Imitrex. She has tried nortriptyline 25mg before bedtime for the past month without success for prevention. She has no other medical problems and is not taking other medications & is not pregnant. Her vital signs are normal.