CNS Drugs

, Volume 16, Issue 6, pp 385–403 | Cite as

Practical Approaches to Migraine Management

  • Seymour Diamond
  • Richard Wenzel
Therapy in Practice


Migraine is a recurrent clinical syndrome characterised by combinations of neurological, gastrointestinal and autonomic manifestations. The exact patho-physiological 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-HT1b/1d agonists (the ‘triptans’) 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.


Migraine Sumatriptan Migraine Attack Zolmitriptan Ergotamine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No financial or other benefits were provided to the authors for the preparation of this manuscript.


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Copyright information

© Adis International Limited 2002

Authors and Affiliations

  • Seymour Diamond
    • 1
  • Richard Wenzel
    • 2
  1. 1.Diamond Inpatient Headache Unit, Diamond Headache ClinicSt. Joseph Hospital, and Finch University of Health Sciences/The Chicago Medical School, North ChicagoChicagoUSA
  2. 2.Diamond Inpatient Headache UnitSt. Joseph Hospital, and University of Illinois-Chicago, College of PharmacyChicagoUSA

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