CNS Drugs

, Volume 16, Issue 6, pp 385–403

Practical Approaches to Migraine Management

  • Seymour Diamond
  • Richard Wenzel
Therapy in Practice

Abstract

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.

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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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