Related Experiment Videos
Acute Treatment of Migraine
1Dokuz Eylül University, Medical Faculty, Department of Neurology, İzmir, Turkey.
Abstract:
Migraine is one of the most frequent disabling neurological conditions with a major impact on the patient's quality of life. Migraine has been described as a chronic disorder that characterized with attacks. Attacks are characterized by moderate-severe, often unilateral, pulsating headache attacks, typically lasting 4 to 72 hours. Migraine remains underdiagnosed and undertreated despite advances in the understanding of its pathophysiology. This article reviews management of migraine acute pharmacological treatment. Currently, for the acute treatment of migraine attacks, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans (serotonin 5HT1B/1D receptor agonists) are recommended. Before intake of NSAID and triptans, metoclopramide or domperidone is useful. In very severe attacks, subcutaneous sumatriptan is first choice. The patient should be treated early in the attack, use an adequate dose and formulation of a medication. Ideally, acute therapy should be restricted to no more than 2 to 3 days per week to avoid medication overuse.
Insights
Effective migraine management involves early treatment with appropriate acute pharmacological therapies like NSAIDs or triptans. Limiting acute treatment to 2-3 days weekly is crucial to prevent medication overuse headaches.
Area of Science:
- Neurology
- Pharmacology
Background:
- Migraine is a prevalent, disabling neurological disorder significantly impacting patient quality of life.
- Despite advances in understanding, migraine remains underdiagnosed and undertreated.
- Migraine attacks are defined by moderate-severe, pulsating headaches lasting 4-72 hours.
Purpose of the Study:
- To review the acute pharmacological management of migraine attacks.
- To provide guidance on effective treatment strategies for migraineurs.
Main Methods:
- Review of current literature on acute migraine treatment.
- Analysis of recommended pharmacological interventions.
Main Results:
- Non-steroidal anti-inflammatory drugs (NSAIDs) and triptans are recommended for acute migraine treatment.
- Metoclopramide or domperidone can be beneficial before NSAIDs and triptans.
- Subcutaneous sumatriptan is the first choice for very severe attacks.
Conclusions:
- Early treatment with adequate doses and formulations is essential for acute migraine management.
- Restricting acute therapy to 2-3 days per week helps avoid medication overuse.
- Optimizing acute pharmacological treatment improves patient outcomes and quality of life.