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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
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Migraine Management in Medically Complex Patients: a Narrative Review
Megan A Hird1, Claire H Sandoe2,3
1Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada.
Current Neurology and Neuroscience Reports
|July 29, 2024
Summary
Migraine treatments for complex patients are available. Gepants and OnabotulinumtoxinA are generally safe for those with cardiovascular, liver, or kidney disease, but more research is needed.
Area of Science:
- Neurology
- Pharmacology
- Internal Medicine
Background:
- Migraine management in patients with comorbidities presents unique challenges.
- Medically complex patients often have contraindications for standard migraine therapies.
Purpose of the Study:
- To review migraine treatment strategies for patients with renal, liver, and cardiovascular disease.
- To identify safe and effective acute and preventive therapies for complex migraine populations.
Main Methods:
- Literature review of current migraine treatment guidelines and studies.
- Analysis of drug safety profiles in patients with specific organ impairments.
Main Results:
- Gepants are recommended for acute therapy in cardiovascular disease; NSAIDs, ergotamines, and triptans are contraindicated.
- Frovatriptan, TCAs, valproic acid, and OnabotulinumtoxinA have favorable safety profiles in renal and/or hepatic disease.
- CGRP monoclonal antibodies show promise but require further investigation in complex populations.
Conclusions:
- Effective migraine treatment options exist for patients with cardiovascular, renal, and hepatic comorbidities.
- Further research is essential to establish definitive safety and dosing for newer migraine therapies in complex patient groups.
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