Treating Early Versus Treating Mild: Timing of Migraine Prescription Medications Among Patients With Diagnosed Migraine

Abstract

These results suggest that patients with migraine often delay their treatment until they have identified their attack as a migraine. In addition, while many patients treated their follow-up headache early, they did not treat when the pain was mild. This suggests that there is an opportunity for physicians to educate their migraine patients on how to differentiate migraine from other headache types and about when and how to use their acute-migraine medication.

Psychological Approaches to Headache

“…112 Further, between 40% and 85% of individuals with headache often wait to take acute medication (especially migraine-specific medication) until the headache is moderate or severe, rather than taking the medication earlier when the pain is mild (which is associated with better treatment outcomes). 111,113,114 Patients describe concerns about side effects and perceived dangerousness of prescription (as opposed to over-the-counter) medication as contributing to this delay. However, patients also describe difficulty identifying an acute headache as a migraine (as opposed to a tension-type headache) early during the course of the headache.…”

“…110,111 However, many patients do not use a migraine-specific medication initially but instead rely on non-specific pain medications. 112 Further, between 40% and 85% of individuals with headache often wait to take acute medication (especially migraine-specific medication) until the headache is moderate or severe, rather than taking the medication earlier when the pain is mild (which is associated with better treatment outcomes).…”

Treating Migraine Attacks ASAP: Concept and Methodological Issues

“…Although the same level of pain intensity may be reached ultimately in the two types of attacks, it will take longer in the slowly progressing type. Treating early may be the same as treating mild pain in a slowly progressing migraine attack, but early treatment may not equate with treatment of mild pain in a rapidly progressing migraine attack (Foley et al, 2005). If early and late treatment are to be compared fairly without considering pain intensity, the comparison needs to be made in one type of attack group only, either in those with slowly progressing attacks (in whom early treatment will equate with treatment of mild pain) or in those with rapidly progressing attacks (in whom treating early does not always mean treating mild pain).…”

A Complete Review of Migraine

“…It is best used in combination with antiemetics and non-steroidal anti-inflammatory drugs (NSAID's). Adverse effects include serotonin syndrome when used in combination with selective serotonin reuptake inhibitors and it should be used with caution in patients having ischemic heart disease [14][15][16][17][18][19][20][21][22]. Characteristics of triptans are summarized in Table 2.…”