[Alternatives to beta blockers in preventive migraine treatment].
Drug prevention of migraine is recommended if more than three attacks occur per month, acute drug treatment is insufficient, or very severe attacks with aura are the main problem. Besides beta blockers, a variety of substances have proved efficacious in migraine prevention. Thus individualised treatment of migraine patients is possible. When choosing the appropriate preventive drug, the potential side effects are considered. Drugs of first choice, besides beta blockers, are flunarizine, valproic acid, and topiramate. Second-choice drugs with lower efficacy or less well published evidence include amitriptyline, venlafaxine, gabapentin, naproxen, acetylsalicylic acid, butterbur root, vitamin B2, and magnesium. Flunarizine or propranolol are recommended for children.
Evers
S
S
Klinik und Polklinik für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Strasse 33, 48129, Münster, Deutschland. everss@uni-muenster.de
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000639:Amitriptyline / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000517:prevention & control*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D018781:Tension-Type Headache / Q000517:prevention & control
D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D002121:Calcium Channel Blockers; D000639:Amitriptyline; D019274:Botulinum Toxins, Type A