Migraine prevention

doi:10.1136/bmjusa.01030002

BMJ, doi: 10.1136/bmjusa.01030002, (Published 5 September 2002)

Editorials

Migraine prevention

The choices continue to grow

Papers BMJ USA p 91

The first 150 words of the full text of this article appear below.

This article originally appeared in BMJ USA

In the last 10 years, the management of migraine headache has changed dramatically. The addition of the triptans has beena breakthrough in the treatment of acute migraine headache. Theeffectiveness of these medications in relieving the severe pain,disability, and other migraine-associated symptoms has reducedthe proportion of patients who require prophylaxis for episodicmigraine. Even frequently occurring migraines can be effectivelytreated with acute medicationsalone.

Clinicians and patients are now faced with the difficult decision of when to start prophylactic drugs. It is estimated thatpreventive therapies are used by only 3% to 5% of migraineurs. ¹ ² Circumstances indicating the need for preventive treatment include:a) two or more disabling headaches per month; b) ineffective symptomatictreatment; c) use of abortive medication more than twice per week;and d) migraines with potential neurological sequelae.³

The mechanisms by which prophylactic drugs reduce migraine . . . [Full text of this article]

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