Acute and prophylactic treatment of migraine: practical approaches and pharmacologic rationale.

Abstract:

:The antimigraine efficacy of many drugs may be mediated less through their primary modes of action than through the common pathway of serotonergic transmission stabilization. Migraine treatment may be symptomatic, acute/abortive, or prophylactic. Because oral drug absorption is impaired during attacks, parenteral agents are more appropriate for acute therapy. Acute agents include ergots and ergotamine derivatives, narcotics, and sumatriptan succinate. Agents that activate the 5-HT3 receptors must be administered with an antiemetic. Sumatriptan succinate, a specific 5-HT1 receptor agonist, does not necessitate adjunctive antiemetics. Stabilization regimens, such as those using valproate, may favorably alter the natural history of migraine. Sumatriptan succinate is appropriate both for acute attacks and for symptomatic management during stabilization. beta-Blockers, tricyclic antidepressants, and calcium antagonists may be used prophylactically.

journal_name

Neurology

journal_title

Neurology

authors

Raskin NH

subject

Has Abstract

pub_date

1993-06-01 00:00:00

pages

S39-42

issue

6 Suppl 3

eissn

0028-3878

issn

1526-632X

journal_volume

43

pub_type

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