RT Journal Article
SR Electronic
T1 Guidelines for the prevention of migraine
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 7
OP 12
VO 5
IS 1
A1 Dirk Deleu
A1 Yolande Hanssens
YR 2000
UL http://nsj.org.sa/content/5/1/7.abstract
AB Treatment of migraine has traditionally been divided into managing acute attacks and prophylactic treatment. Treatment of acute migraine has been the subject of many research papers and review articles in recent literature partly at the cost of prophylactic treatment, which is the focus of this review. The objective of prophylactic therapy is to reduce frequency, duration and severity of attacks in addition to optimize the patient’s ability to function normally. Preventive therapy is usually undertaken in patients who have more than two migraine episodes per month or when less frequent have severely disabling headaches resistant to usual treatment. Beta-blocking drugs without intrinsic sympathomimetic activity (e.g. propranolol) are usually the first drugs of choice followed by tricyclic antidepressant agents (e.g. amitriptyline), non-steroidal anti-inflammatory drugs (e.g. naproxen), calcium antagonists (e.g. flunarizine) or valproate. The use of serotonin antagonists (e.g. methysergide) is limited because of their potential serious side effects. Migraine refractory to standard prophylactic therapy is very often the result of overuse of abortive antimigraine drugs. The choice of medication clearly depends on the patient’s profile (age, co-morbid medical conditions) and the contraindication and side effect profile of the drug.