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Symptomatic pharmacotherapy of migraine
B L Lobo1, S C Cooke, S H Landy
1Department of Pharmacy, Methodist Healthcare-Central, Memphis, Tennessee 38104, USA.
Clinical Therapeutics
|August 27, 1999
Summary
This review examines migraine pharmacotherapies, recommending NSAIDs and simple analgesics for mild headaches. For severe or resistant migraines, triptans and ergot alkaloids offer effective treatment options.
Area of Science:
- Neurology
- Pharmacology
Background:
- Migraine is a common neurological disorder with various treatment options.
- Effective symptomatic treatment is crucial for managing migraine headaches.
Purpose of the Study:
- To review the effectiveness of symptomatic migraine pharmacotherapies.
- To provide recommendations for migraine treatment based on a stepped-care or stratified approach.
Main Methods:
- Review of existing data on various migraine pharmacotherapies.
- Analysis of treatment approaches including stepped-care and stratified care models.
Main Results:
- Simple analgesics and NSAIDs are recommended first-line treatments for mild-to-moderate migraines.
- Ergots, combination products, dopamine antagonists, and triptans are second-line options.
- Triptans (e.g., sumatriptan, rizatriptan, naratriptan) and dihydroergotamine are effective for severe or refractory migraines, with varying onset and recurrence rates.
Conclusions:
- Treatment should be individualized based on headache severity and patient factors.
- A stepped-care or stratified approach ensures appropriate pharmacotherapy selection.
- Triptans offer diverse options for symptomatic migraine relief.