Migraine

The enormous economic cost of migraine attacks is only now becoming evident. One estimate is that they cost $6 billion per year in the United States alone. If treatments are effective enough to keep patients at work, considerable expenditure for treatment can be justified. Most patients never seek medical advice, and one assumes that their headaches are under satisfactory control with simple over-the-counter analgesics. The minority seeking medical advice, who suffer the bulk of absences from work and loss of efficacy, should be offered treatment potent enough to enable them to function normally, if possible. The new serotonin agonist triptan drugs are proving immensely valuable, and there is little doubt that they are cost effective in patients who are severely affected. One should always be aware of the potential for these medications to cause headache if taken in excess. Regular preventive treatment and potent analgesia should be considered in patients with frequent spontaneous attacks of headache.