Overview of diagnosis and treatment of migraine.
Optimal migraine therapy begins with an accurate diagnosis and knowledge of the symptoms that the patient finds most disturbing. Pharmacologic treatment of migraine may be acute (abortive, symptomatic) or preventive (prophylactic); both approaches are frequently required in patients with frequent, severe headaches. Drugs for acute care consist of analgesics, antiemetics, anxiolytics, nonsteroidal anti-inflammatory drugs, ergots, steroids, major tranquilizers, narcotics, and selective serotonin agonists. Preventive agents include beta-blockers, calcium channel blockers, antidepressants, serotonin antagonists, and anticonvulsants. The choice of a preventive drug depends on side effect profiles and comorbid conditions. Behavioral interventions, such as biofeedback and relaxation techniques, are an important complement to pharmacologic therapy; however, drugs are the mainstay of migraine therapy. To ensure that therapy achieves optimal results, the individual patient's preferred approach to this debilitating problem must be considered carefully.
Silberstein
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Comprehensive Headache Center, Germantown Hospital and Medical Center, Philadelphia, Pennsylvania.
Lipton
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D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004087:Dihydroergotamine / Q000627:therapeutic use; D004878:Ergotamine / Q000627:therapeutic use; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D012702:Serotonin Antagonists / Q000627:therapeutic use; D018170:Sumatriptan / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D002121:Calcium Channel Blockers; D012702:Serotonin Antagonists; D004087:Dihydroergotamine; D018170:Sumatriptan; D004878:Ergotamine