The preventive treatment of migraine.
BACKGROUND
Migraine is a common, chronic, and disabling disorder. The treatment of migraine includes a combination of nonpharmacologic and pharmacologic techniques. Pharmacologic approaches are subdivided in preventive therapies and acute care.


RESULTS
In this review article, we review the current approaches to the preventive treatment of migraine. Preventive treatment should be initiated in those with frequent or disabling headaches. The goals include (1) reducing attack frequency, intensity, and duration; (2) minimizing headache-related disability; (3) improving health-related quality of life; (4) avoiding headache escalation and medication misuse. In this article, we also discuss the principles of migraine prevention, as well as drugs available for this goal. We divide preventive medications on those of common use, nutraceutical compounds, and medications less frequently used. We close by briefly discussing some in-development potential preventive drugs.


CONCLUSIONS
Preventive therapies are well suitable for migraineurs with attack-related disability despite appropriate acute care.
Bigal
Marcelo E
ME
Departments of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA. mbigal@aecom.yu.edu
Lipton
Richard B
RB
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000627:therapeutic use; D000529:Complementary Therapies; D006801:Humans; D008881:Migraine Disorders / Q000453:epidemiology / Q000517:prevention & control*; D018373:Peripheral Nervous System Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D002491:Central Nervous System Agents; D018373:Peripheral Nervous System Agents