The Italian Journal of Neurological Sciences

, Volume 16, Issue 8, pp 577–586 | Cite as

A review of the treatment of primary headaches. Part I: Migraine

  • Leone M. 
  • Grazzi L. 
  • D'Amico D. 
  • Moschiano F. 
  • Bussone G. 
Review

Abstract

Finding the best treatment for a patient's migraine is often a problem in clinical practice since the condition is very common, often debilitating and may prove refractory to therapy. Over recent years, more effective migraine treatments have been found and validated, and the traditional remedies have undergone controlled testing. This article reviews the various therapies available for both the acute treatment and prevention of migraine. Treatments often effective against migraine attacks are: aspirin, analgesics, non steroid antiinflammatory drugs (NSAIDs), ergot derivatives and sumatriptan. Five main classes of prophylactic drug are currently used: beta-blockers, calcium antagonists, serotonin modulators, NSAIDs and ergot compounds. Biofeedback, one of the most efficacious non-pharmacological preventive treatments of migraine, is also discussed.

The variables influencing the choice of acute and preventive treatments, including contriandications and drug availability, are also described in order to provide a practical and up-to-date guide to migraine therapy.

Key Words

Migraine Acute treatment Prophylaxis Biofeedback Status migrainosus 

Sommario

L'emicrania è un disturbo che colpisce circa il 15% della popolazione generale risultando spesso debilitante tale da risultare un problema clinico di rilievo soprattutto quando refrattario alla terapia. Questo articolo fornisce una guida razionale ed aggiornata al trattamento di questa malattia, sia per gli attacchi che per la profilassi. Per quanto riguarda gli attacchi i farmaci risultati efficaci nei diversi studi clinici controllati sono l'aspirina, gli analgesici, gli antiinfiammatori non steroidei, gli ergot derivati ed il sumatriptan. I farmaci riconosciuti efficaci nella profilassi dell'emicrania sono identificabili tra 5 principali categorie di sostanze: beta-bloccanti, calcio antagonisti, serotonino-modulatori, antiinfiammatori non steroidei e gli ergot derivati. Tra le terapie non farmacologiche, viene brevemente discussa l'utilità del biofeedback nella prevenzione di alcune forme di emicrania.

Vengono inoltre discusse le numerose variabili che influenzano la scelta del farmaco sia per la profilassi che per l'attacco con le relative controindicazioni.

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Copyright information

© Masson Italia Periodici S.r.l. 1995

Authors and Affiliations

  • Leone M. 
    • 1
  • Grazzi L. 
    • 1
  • D'Amico D. 
    • 1
  • Moschiano F. 
    • 1
  • Bussone G. 
    • 1
  1. 1.Centro CefaleeIstituto Neurologico Carlo BestaMilanoItaly

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