Migraine management. Focus on meeting patients' individual needs

Guidelines for the management of migraine recommend that treatment approaches be tailored to patients' individual goals and needs. Because of significant interpatient and intrapatient variability in migraine attributes, treatment strategies suitable for some patients or migraine episodes are not necessarily suited to others. As never before, the current migraine armamentarium allows flexible, individualized therapy for meeting such goals and needs. This paper discusses pharmacologic and nonpharmacologic approaches to customizing migraine therapy to the needs of the individual patient. Migraine management, while not complicated, is an ongoing process, requiring partnership of the physician and patient. In addition to the use of triptans as first-line therapy for acute treatment, preventive treatment strategies, including the relatively new approach of intermittent or pulsed prevention, can be useful. Besides pharmacotherapy, the nonpharmacologic aspects of migraine management should be an integral part of treatment. Patients should be monitored frequently so that treatment response can be determined and therapy adjusted as appropriate.