title: Drug safety and tolerability in prophylactic migraine treatment.
abstract: BACKGROUND
  Migraine is a frequent, disabling primary headache disorder, whose pathomechanism is not yet fully understood. Prophylactic treatment is advisable for migraineurs with severe or highly frequent attacks, which impair the quality of life.
  
  
  METHODS
  The different types of prophylactic migraine drugs are discussed, with particular regard to potential adverse effects and safety issues. β-Adrenergic blockers, antiepileptic drugs and calcium-channel blockers are drugs widely used for migraine prevention, whereas complementary medicine and onabotulinumtoxin A can be used in selected cases.
  
  
  CONCLUSIONS
  The background of the recurrence and chronification of migraine attacks has not been fully clarified, and causative preventive therapy is therefore not currently available. The tolerability and adverse effects of the currently used medications often limit their use. β-Adrenergic receptor blockers may induce adverse cardiovascular events, whereas flunarizine is frequently associated with a weight gain and depression. As most migraine sufferers are young women of child-bearing age, the use of valproate is limited. Topiramate is associated with central nervous system-related side effects. There is a need for future development of pathomechanism-based preventive drugs, and personalized therapy tailored to the patient.
authors: University of Szeged, Department of Neurology , Semmelweis u. 6, H-6725 Szeged , Hungary +36 62 545348 ; +36 62 545597 ; vecsei.laszlo@med.u-szeged.hu.
authors: László
authors: L
authors: Vécsei
authors: Zsófia
authors: Z
authors: Majláth
authors: Délia
authors: D
authors: Szok
authors: Anett
authors: A
authors: Csáti
authors: János
authors: J
authors: Tajti
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use; D000529:Complementary Therapies / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000517:prevention & control*; D057285:Precision Medicine / Q000379:methods*; D011788:Quality of Life
chemical_list: D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D002121:Calcium Channel Blockers; D019274:Botulinum Toxins, Type A
keywords: efficacy; migraine; prophylactic treatment; safety; tolerability