Acute drug treatment of migraine attack

The availability of an effective drug for attack treatment is a main need of migraine patients. Symptomatic therapy of migraine now includes three main classes of drugs: ergot alkaloids, nonsteroidal antiinflammatory drugs (NSAIDs) and triptans. Clinical randomised placebo-controlled trials affirmed the efficacy and tolerability of these drugs, when used at the recommended doses and in the absence of contraindications. The efficacy data from comparative trials showed a trend in favour of triptans vs. ergot alkaloids, but failed to show significant differences between triptans and NSAIDs. However, clinical practice experience of most headache clinicians suggests that triptans provide superior efficacy in comparison with nonspecific agents, mainly in that they better satisfy migraine patient expectations. In fact, these selective specific antimigraine drugs are an advance in acute migraine treatment.