J Korean Med Assoc.  2007 Oct;50(10):917-923. 10.5124/jkma.2007.50.10.917.

Drug Therapy for Migraine

Affiliations
  • 1Department of Neurology, Sungkyunkwan University School of Medicine, Korea. cschung@smc.samsung.co.kr

Abstract

Migraine significantly disturbs the quality of life of the patients by causing severe throbbing headache associated with neurological, autonomic, and gastrointestinal symptoms. Management of migraine starts from the correct diagnosis based on the classification proposed by the International Headache Society in 2004. Treatment failure and medication overuse and abuse commonly result from misdiagnosis of specific type of headache. Treatment includes: (1) nonpharmacological therapy (patient education, regular exercise, abstinence of caffeine and alcohol drinking, avoidance of fasting, and regular sleep), (2) acute pharmacological therapy (simple analgesics, NSAIDs, ergotamines, triptans, etc.), and (3) prophylactic pharmacological therapy (beta- blockers, calcium channel blockers, antidepressants, and anticonvulsants). Because individual drugs have their unique properties and drug interactions, careful selection and combination of the drugs must be made on the basis of the patient's migraine type, associated symptoms, and comorbidities. One of the complications of migraine drug therapy is transformation of episodic migraine into chronic daily headache that is caused by abuse or overuse of anti-migraine drugs. So the correct diagnosis of migraine and appropriate pharmacological and non-pharmacological treatments are of utmost importance in improving the patient's quality of life and prevention of medication-overuse headache.

Keyword

Migraine; Nonpharmacological therapy; Acute abortive therapy; Triptans; Prophylctic therapy

MeSH Terms

Alcohol Drinking
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Antidepressive Agents
Caffeine
Calcium Channel Blockers
Classification
Comorbidity
Diagnosis
Diagnostic Errors
Drug Interactions
Drug Therapy*
Education
Ergotamines
Fasting
Headache
Headache Disorders
Humans
Migraine Disorders*
Quality of Life
Treatment Failure
Tryptamines
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Antidepressive Agents
Caffeine
Calcium Channel Blockers
Ergotamines
Tryptamines
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