8. Acute Treatments for Migraine

  1. Matthew S. Robbins MD,
  2. Brian M. Grosberg MD and
  3. Richard B. Lipton MD
  1. Dagny Holle and
  2. Hans-Christoph Diener

Published Online: 19 JUL 2013

DOI: 10.1002/9781118678961.ch8

Headache

Headache

How to Cite

Holle, D. and Diener, H.-C. (2013) Acute Treatments for Migraine, in Headache (eds M. S. Robbins, B. M. Grosberg and R. B. Lipton), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118678961.ch8

Editor Information

  1. Montefi ore Headache Center, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA

Author Information

  1. University of Duisburg-Essen, Essen, Germany

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9780470654729

Online ISBN: 9781118678961

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Keywords:

  • Acute treatment;
  • migraine;
  • pain relieving medication;
  • triptans;
  • ergot alkaloids;
  • pregnancy;
  • breastfeeding;
  • status migrainosus

Summary

Acute migraine treatment includes various non-pharmacological and pharmacological strategies that must be adapted to the individual patients' needs with regard to clinical history, headache intensity, frequency, temporary disability, previous side effects, and accompanying symptoms such as nausea and vomiting. Drug treatment can be divided into migraine- nonspecific therapies such as nonsteroidal anti-inflammatory drugs, nonopioids, combination analgesics, and into migraine specific medications, such as 5HT1B/1D agonists (“triptans”), and ergot alkaloids or derivates. Antiemetics and neuroleptics might be accessorily prescribed to support therapy. Possible acute treatment options are reported with regard to efficacy, side effects, contraindications and special noteworthy features. Additionally, specific treatment situations such as migraine attacks during pregnancy and breastfeeding, in the emergency room, during childhood, in elderly patients, and in menstrual migraine are discussed.