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[Update on migraine prophylactic treatment].

A V Krymchantowski1, P F Moreira Filho

  • 1Centro de Avaliação e Tratamento da Dor de Cabeça do Rio de Janeiro, Brasil. abouchkrym@openlink.com.br

Arquivos De Neuro-Psiquiatria
|August 18, 1999
PubMed
Summary

Migraine is a common primary headache affecting 12% of the population, particularly women. Preventive treatments, though their exact mechanisms are unclear, significantly reduce migraine frequency and intensity.

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Area of Science:

  • Neurology
  • Pharmacology

Context:

  • Migraine is a prevalent primary headache disorder, frequently leading individuals to seek medical attention.
  • Affecting 12% of the population, migraine disproportionately impacts women (18-20%) compared to men (6%) and children (4-8%).
  • The economic and personal impact is substantial, with incapacitating headache attacks disrupting daily activities.

Purpose:

  • To review the current landscape of preventive treatments for migraine.
  • To discuss various classes of medications used for migraine prophylaxis.
  • To explore proposed mechanisms of action for these preventive therapies.

Summary:

  • The most effective migraine management involves trigger avoidance, preventive therapy, acute pain relief, and non-pharmacological approaches.
  • Preventive medications include beta-blockers, tricyclic antidepressants, SSRIs, calcium antagonists, and anticonvulsants.

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  • While mechanisms are not fully elucidated, these drugs appear to modulate central neurotransmitter systems (serotonergic, noradrenergic, GABAergic) and ion channels.

    • Impact:

    • Individualized and appropriate use of preventive medications can significantly decrease migraine episode frequency and intensity.
    • Effective prophylaxis alleviates patient suffering and reduces reliance on ineffective or uncertain treatment strategies.
    • Advances in understanding drug mechanisms may lead to more targeted and effective migraine therapies.