PMID: 6406072Mar 1, 1983Paper

Treatment of the acute migraine attack--current status

Cephalalgia : an International Journal of Headache
M Wilkinson

Abstract

The main treatment of the acute migraine attack remains sleep, sedation, an anti-nauseant and analgesics, and in some patients 1 or 2 mg of ergotamine tartrate. Drugs containing large amounts of caffeine should not be used. Absorption of drugs may be impaired in a migraine attack. Metoclopramide is probably the anti-emetic of choice because it is an effective anti-nauseant and promotes normal gastrointestinal activity. Domperidone has a similar action but is said not to go through the blood-brain barrier, so is less likely to cause extrapyramidal reactions. All drugs, including analgesics such as aspirin and paracetamol, are best given in a soluble or effervescent form. Where vomiting occurs early in the attack, suppositories may be indicated. Ergotamine tartrate is necessary in about one third of attacks and is best given by suppository or by inhalation. Doses higher than 2 mg per attack or 6 mg in one week may cause toxic symptoms, the early signs of which are headache, nausea, vomiting and a feeling of not being very well. The non-drug treatments of an acute attack include pressing on the temporal artery, hot and cold compresses and relaxation.

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Citations

Dec 14, 2005·Current Treatment Options in Neurology·Robert Kaniecki
Mar 10, 2004·BMC Neurology·Abouch Valenty Krymchantowski
Sep 1, 2006·Neuropsychiatric Disease and Treatment·Abouch Valenty Krymchantowski
Jun 1, 1986·Cephalalgia : an International Journal of Headache·P M BülowP Tfelt-Hansen
Dec 1, 1984·Cephalalgia : an International Journal of Headache·R A TokolaO Tokola
Jun 21, 2007·Headache·Lauren D LaPorta
Apr 28, 2005·Expert Review of Neurotherapeutics·Abouch Valenty Krymchantowski, Marcelo Eduardo Bigal
Apr 28, 2005·Expert Review of Neurotherapeutics·Abouch Valenty Krymchantowski
Mar 15, 2006·Expert Review of Neurotherapeutics·Abouch Valenty Krymchantowski, Marcelo Eduardo Bigal
Aug 2, 2003·Headache·Elliott A Schulman, Kathleen F Dermott
Oct 1, 1995·Cephalalgia : an International Journal of Headache·M WilkinsonT J Steiner
Feb 15, 2013·Headache·Elliott Schulman
Apr 16, 2019·Cephalalgia : an International Journal of Headache·Tarannum LateefKathleen Ries Merikangas

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