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Acute Migraine Treatment.

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    Area of Science:

    • Neurology
    • Pharmacology

    Background:

    • Migraine is a common neurological disorder.
    • Acute treatment is crucial for managing migraine attacks.

    Purpose of the Study:

    • To provide a systematic, evidence-based approach to selecting acute migraine medications.
    • To outline effective treatment strategies for various migraine severities and patient profiles.

    Main Methods:

    • Systematic review of clinical trials, meta-analyses, and practice guidelines.
    • Evidence-based evaluation of acute migraine medications.

    Main Results:

    • Four NSAIDs (ibuprofen, naproxen sodium, diclofenac potassium, acetylsalicylic acid) and seven triptans are confirmed effective for acute migraine.
    • Dihydroergotamine (DHE) is suitable for select patients.
    • Acetaminophen is the safest acute migraine option during pregnancy.

    Conclusions:

    • NSAIDs and triptans are mainstays of acute migraine therapy; antiemetics can be added.
    • Opioids should not be used routinely.
    • Treatment strategies include acetaminophen-NSAID for mild-moderate, triptans for severe/NSAID-refractory, and combination/DHE/rescue for refractory migraines.