Acute treatment of migraine.
The goals of acute treatment of migraine are cost-effective rapid relief, consistent reduction of disability, and reduced use of rescue medications. Key to acute treatment is matching medication to disability as a surrogate marker for disease severity with a stratified care approach. In the absence of vascular contraindications, triptans are first-line acute treatments for disabling migraine. Acute treatment success can be assessed with use of the paper tool, Migraine-ACT. Opioids and butalbital should be avoided in acute migraine treatment. Triptan type can be selected for patients by differences in speed or effect, formulation, and formulary tier.
Tepper
Stewart J
SJ
Center for Headache and Pain, T33, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. teppers@ccf.org
Spears
Roderick C
RC
D004638:Emergency Treatment; D004878:Ergotamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014363:Tryptamines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D014363:Tryptamines; D014662:Vasoconstrictor Agents; D004878:Ergotamine