Pharmacological prevention of migraine

Fenstermacher, Nathan; Levin, Morris; Ward, Thomas N.

doi:10.1136/bmj.d583

Cited by 28 publications

(24 citation statements)

References 25 publications

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“…Accepted criteria for beginning prophylactic therapy include very frequent migraines, insufficient relief from acute migraine treatment and attacks that considerably impede activities of daily life [13,16,61]. The primary indicator for initiating prophylactic treatment has shifted from the frequency of attacks towards the impact on the patient, with reference to functional disability and quality of life [61]. Nevertheless, disability and side effects must be balanced.…”

Section: Migraine Prophylaxis When To Start Prophylactic Therapymentioning

confidence: 99%

“…When to start prophylactic medication is controversial, and detailed guidelines on when to correctly initiate preventive therapy differ among different countries and organizations. Accepted criteria for beginning prophylactic therapy include very frequent migraines, insufficient relief from acute migraine treatment and attacks that considerably impede activities of daily life [13,16,61]. The primary indicator for initiating prophylactic treatment has shifted from the frequency of attacks towards the impact on the patient, with reference to functional disability and quality of life [61].…”

Section: Migraine Prophylaxis When To Start Prophylactic Therapymentioning

confidence: 99%

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Overview of Migraine Treatment

Bozoghlanian

Vasudevan²

2012

Pain Manage.

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SUMMARY Migraine is ranked as the 19th top cause of disability worldwide by WHO. Despite advancements in migraine-specific acute treatment, only a minority of patients utilize these medications. Specific pharmacologic treatments consist of the ergot alkaloids and triptans (serotonin 5-HT1B/1D receptor agonists). Both classes are regarded as relatively safe and effective; however, there is a greater concern for vasoconstrictive effects with the ergots, which limits their use. Triptans transformed migraine therapy, setting in motion revolutionary research that heightened our understanding of migraine mechanisms. However, one in three migraineurs may be triptan nonresponders and there is a group of migraine patients that remains 'refractory' to conventional pharmacologic migraine therapy. This article discusses the approach to migraine management, reviews currently available acute and preventive pharmacologic and nonpharmacologic treatment options for migraine headache, as well as briefly focuses on novel and upcoming medicines presently under investigation.

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Section: Migraine Prophylaxis When To Start Prophylactic Therapymentioning

confidence: 99%

Section: Migraine Prophylaxis When To Start Prophylactic Therapymentioning

confidence: 99%

Overview of Migraine Treatment

Bozoghlanian

Vasudevan²

2012

Pain Manage.

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“…The primary objective of prophylactic treatment is to reduce the severity, frequency and duration of migraine attacks. Although pharmacological options such as propranolol, topiramate and amitriptyline remain the mainstay of prophylactic treatment [29] a significant proportion of patients struggle either due to adverse effects or lack of efficacy [30,31]. These patients often resort to non-pharmacological measures.…”

Section: Treatment Of Migrainementioning

confidence: 99%

Acupuncture in Primary Headache Disorders; Review of the Evidence

Zaidi¹,

Ahme²

2016

J Neurol Disord

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Primary headache disorders affect large number of people worldwide. Migraine and tension type headaches constitute 95% of all headaches. Both tension type headaches and migraine impose huge socioeconomic impact on society. The role of non-pharmacological interventions in management of primary headaches is not entirely clear. Acupuncture is one of the most historical non pharmacological ways of treating migraine and tension type headaches. The evidence in support of its effectiveness however is conflicting. This review evaluates the available evidence regarding effectiveness of acupuncture for migraine and tension type headaches.

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“…Aside from diagnostic purposes, botulinum toxin type A injections have also been approved by the U.S. Food and Drug Administration for temporary reduction of migraine headaches. 12 Therapeutic botulinum toxin type A injections are administered in multiple sites per visit in the head and neck to induce maximal effect on migraine headaches. 12 In contrast, preoperative diagnostic botulinum toxin type A injections are administered at one trigger site per visit, starting with the most common and severe trigger site based on the patient's constellation of symptoms.…”

mentioning

confidence: 99%

“…12 Therapeutic botulinum toxin type A injections are administered in multiple sites per visit in the head and neck to induce maximal effect on migraine headaches. 12 In contrast, preoperative diagnostic botulinum toxin type A injections are administered at one trigger site per visit, starting with the most common and severe trigger site based on the patient's constellation of symptoms. If necessary, subsequent trigger-site injections are given 1 month apart, up to a maximum of three sites, until all trigger sites are confirmed.…”

mentioning

confidence: 99%