Prophylactic pharmacotherapy for migraine headaches

Seminars in Neurology
Thomas M Buchanan, N M Ramadan

Abstract

Migraine therapeutics are pharmacological, including acute and preventive, nonpharmacological and/or both. Preventive pharmacological strategies serendipitously were discovered to be effective and include drugs from various pharmacological classes (e.g., beta-adrenergic blocker, anticonvulsant, tricyclic antidepressants, serotonin receptor antagonist). Converging level I evidence and clinical experience support the use of the antidepressant amitriptyline, the anticonvulsants divalproex and topiramate, and the beta-adrenergic blockers propranolol, timolol, and metoprolol in migraine prevention. Other options for migraine prophylaxis exist, but the level of evidence in support of their use is not as robust. All of these drugs have varying degrees of adverse effects, some of which can limit their use. Balancing potential efficacy with risk of adverse effects, addressing patients' expectations and desires, complying with management recommendations, adequate follow up, and accurate assessment of treatment goals are key to migraine prevention. Finally, future migraine-preventive drugs likely will target migraine mechanisms more specifically, which undoubtedly will enhance the therapeutic index.

Citations

Jul 17, 2008·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Gerardo CasucciFabio Frediani
Sep 28, 2010·Plastic and Reconstructive Surgery·Theodore A KungPaul S Cederna
Aug 2, 2008·Clinical Neuropharmacology·Vasilios G MasdrakisConstantin R Soldatos
Feb 12, 2008·European Neurology·R O Millán-GuerreroL M Baltazar
Jul 1, 2010·Patient Related Outcome Measures·Maurizio PompiliPaolo Martelletti
May 11, 2010·Drugs & Aging·Matthew S Robbins, Richard B Lipton
Oct 16, 2014·Drugs & Aging·Stephanie Wrobel GoldbergBrian M Grosberg
Oct 2, 2008·Journal of the American Pharmacists Association : JAPhA·Richard G Wenzel
Apr 9, 2011·Otolaryngologic Clinics of North America·Marcello Cherchi, Timothy C Hain
Aug 6, 2009·Progress in Neurobiology·Francesca GallettiPaola Sarchielli
Apr 12, 2011·The Journal of Headache and Pain·Raffaella PizzolatoGiuliano Sette
Oct 1, 2009·Headache·Pedro Emilio BermejoJose Maria Gomez-Arguelles
May 15, 2009·Headache·Pedro A KowacsStewart J Tepper
Sep 21, 2007·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·R O Millán-GuerreroR Muñoz-Solis
Jan 16, 2008·Headache·Christopher OwensKimball Owens
Jun 14, 2008·Headache·B Lee PeterlinNinan T Mathew
Apr 12, 2007·Headache·Nabih M Ramadan
Jun 27, 2006·Pharmacology & Therapeutics·Nabih M Ramadan, Thomas M Buchanan
Jan 15, 2013·The International Journal of Neuroscience·Arash BostaniMansour Rezaei
Sep 29, 2011·The International Journal of Neuroscience·Dariush AfshariMansour Rezaei
Feb 19, 2014·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·R O Millán-GuerreroG Castillo-Varela
Aug 8, 2012·Continuum : Lifelong Learning in Neurology·Paul B Rizzoli
Apr 20, 2018·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Till SprengerC Tassorelli
May 9, 2012·Indian Pediatrics·K S AnandJoyti Aggarwal
May 27, 2016·JAAPA : Official Journal of the American Academy of Physician Assistants·Lorraine A Sanassi
Jan 10, 2008·Bioorganic & Medicinal Chemistry·Vincent J HuberTsutomu Nakada
Jun 25, 2021·American Journal of Otolaryngology·Lane B DonaldsonHabib G Rizk

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.