Treatment of the migraine attack

Migraine is an episodic headache disorder that occurs with or without aura and is often accompanied by other symptoms. Treatment must address these associated symptoms as well as the headache, and it can involve either acute or preventive therapy alone or a combination of both. Acute therapy treats the individual attack; preventive therapy aims to reduce the frequency and severity of attacks. Drug choice requires careful consideration and depends on the character of the migraine attack. Acute drug therapy using sumatriptan, MK-462, 311C90, dihydroergotamine, nonsteroidal anti-inflammatory drugs, butorphanol, metoclopramide, and domperidone is discussed. Prophylactic drug therapy using valproate and fluoxetine is also discussed.