Clinical approaches to migraine prophylaxis.
Chronic migraine is a recognized complication of episodic migraine. A high frequency of attacks and frequent use of abortive medications are important risk factors associated with conversion to a chronic condition. Prophylaxis is therefore recommended for patients with frequent episodic migraine. The agents approved for migraine prophylaxis are the anti-epileptic agents divalproex and topiramate, and the beta-adrenergic antagonists propranolol and timolol. However, a wide range of other systemic agents and local injections of botulinum toxin have also been used in migraine prophylaxis. The anticipated benefits must be weighed against the adverse effects associated with each agent in determining the optimal preventive regimen for individual patients.
Blumenfeld
Andrew
A
The Headache Center of Southern California, Scripps Memorial Hospital-Encintas, USA.
D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control*; D014481:United States