Practical approaches to migraine management.
Article first published online: 26 FEB 2003
Headache: The Journal of Head and Face Pain
Volume 43, Issue 3, page 304, March 2003
How to Cite
Diamond, S. and Wenzel, R. (2003), Practical approaches to migraine management. Headache: The Journal of Head and Face Pain, 43: 304. doi: 10.1046/j.1526-4610.2003.03062_13.x
- Issue published online: 26 FEB 2003
- Article first published online: 26 FEB 2003
- Cited By
CNS Drugs. 2002;16(6):385-403
Migraine is a recurrent clinical syndrome characterised by combinations of neurological, gastrointestinal and autonomic manifestations. The exact pathophysiological disturbances that occur with migraine have yet to be elucidated; however, cervico-trigemino-vascular dysfunctions appear to be the primary cause. Despite advances in the understanding of the pathophysiology of migraine and new effective treatment options, migraine remains an under-diagnosed, under-treated and poorly treated health condition. Most patients will unsuccessfully attempt to treat their headaches with over-the-counter medications. Few well designed, placebo-controlled studies are available to guide physicians in medication selection. Recently published evidence-based guidelines advocate migraine-specific drugs, such as serotonin 5-HT(1B/1D) agonists (the Ätriptans') and dihydroergotamine mesylate, for patients experiencing moderate to severe migraine attacks. Additional headache attack therapy options include other ergotamine derivatives, phenothiazines, nonsteroidal anti-inflammatory agents and opioids. Preventative medication therapy is indicated for patients experiencing frequent and/or refractory attacks.
Comment: A nicely written, practical review article which I recommend for medical students, residents, and primary care physicians. SJT