Aktuelle Diagnostik und Therapie der Migräne

Diener, Hans Christoph; Katsarava, Zaza; Limmroth, Volker

doi:10.1007/s00482-007-0619-3

Cited by 6 publications

(6 citation statements)

References 63 publications

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“…With a prevalence of 8% in males and 12–15% in females migraine is one of the commonest issues encountered in primary practice [1]. It is characterized by recurrent attacks of pulsatile, unilateral headache often accompanied by nausea and vomiting, photo- and phonophobia.…”

Section: Introductionmentioning

confidence: 99%

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Párdutz

Schoenen

2010

Pharmaceuticals

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Migraine is a common disabling neurological disorder with a serious socio-economical burden. By blocking cyclooxygenase nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the synthesis of prostaglandins, which are involved in the pathophysiology of migraine headaches. Despite the introduction more than a decade ago of a new class of migraine-specific drugs with superior efficacy, the triptans, NSAIDs remain the most commonly used therapies for the migraine attack. This is in part due to their wide availability as over-the-counter drugs and their pharmaco-economic advantages, but also to a favorable efficacy/side effect profile at least in attacks of mild and moderate intensity. We summarize here both the experimental data showing that NSAIDs are able to influence several pathophysiological facets of the migraine headache and the clinical studies providing evidence for the therapeutic efficacy of various subclasses of NSAIDs in migraine therapy. Taken together these data indicate that there are several targets for NSAIDs in migraine pathophysiology and that on the spectrum of clinical potency acetaminophen is at the lower end while ibuprofen is among the most effective drugs. Acetaminophen and aspirin excluded, comparative trials between the other NSAIDs are missing. Since evidence-based criteria are scarce, the selection of an NSAID should take into account proof and degree of efficacy, rapid GI absorption, gastric ulcer risk and previous experience of each individual patient. If selected and prescribed wisely, NSAIDs are precious, safe and cost-efficient drugs for the treatment of migraine attacks.

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Section: Introductionmentioning

confidence: 99%

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Párdutz

Schoenen

2010

Pharmaceuticals

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“…5). Mittel der Wahl sind Metoclopramid und Domperidon, bei Kindern nur Letzteres, da Metoclopramid zu extrapyramidalen Störungen führen kann [3,5]. Bei Kleinkindern und Schwan geren bevorzuge ich selbst Dimenhydrat.…”

Section: Mythos 16: Migränebehandlung Ist Allein Sache Des Neurologenunclassified

“…Schwere der Anfälle, Verträglichkeit der Analgetika, Bedarf an Analgetika und Be gleitkrankheiten fließen in die Entscheidung ein [3,5,8]. So ist es z.…”

Section: Mythos 19: Prophylaxe Ist Nur Sinnvoll Wenn Der Patient Mehunclassified

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Mythos Migräne

Wilhelm¹

2012

Ophthalmologe

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Migraine is the most frequent cause of headache in patients seeking medical advice. Even ophthalmologists are frequently confronted with this diagnosis. In many cases a diagnosis can be easily established by a targeted patient history. Accompanying symptoms deserve attention, especially the aura which often leads patients directly to the ophthalmologist. Concerning migraine therapy well-established guidelines exist but despite this many patients remain undiagnosed and inadequately treated. Many myths and half-truths are associated with migraine headache. This article aims to give an overview for ophthalmologists.

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“…[2] Migraine causes a one-sided throbbing headache of moderate to severe strength and additional symptoms as for example a high sensitivity to sound and / or light and nausea. [3] People of all ages can suffer from migraine, although the first attack most often occurs between the puberty and the 25th year of life. A first occurrence after the 40th life year is very unlikely.…”

Section: Introductionmentioning

confidence: 99%

The treatment of migraine patients with triptans – is there a need for further Rx-to-OTC switches?

Schneider-Ziebe

May

2019

Gesundh ökon Qual manag

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Objective The disease migraine affects a large share of the German population and is linked to a high economic potential in terms of direct and indirect sickness costs. Triptans are the recommended treatment in the case of an acute migraine attack. Both, the disease and its appropriate treatment are of interest in the context of self-medication and Rx-to-OTC switch efforts. Therefore, a survey was carried out with the intention to collect data among migraine patients regarding the use of analgesics in general and of triptans specifically. This data can be the basis for further health economic considerations. Methods By an online survey among 206 migraine patients, different data regarding patients suffering from migraine, the frequency and sort of symptoms and the use of analgesics in general as well as triptans specifically was collected and analysed. A special focus was on symptoms affecting patients’ productivity, their use of triptans and their satisfaction with the current supply situation with triptans. Results The survey revealed among other findings that most patients suffer from symptoms which limit their productivity or their ability to work and make an immediate treatment necessary. Most patients know well about their disease and feel able to treat themselves in the context of self-medication once they are diagnosed by a physician. In this context a demand for further triptans available without a prescription could be identified. This is specifically, because patients respond differently to various triptans. Therefore, a larger variety of prescription free triptans would increase the number of patients with access to OTC triptans significantly. Conclusion Most survey respondents know well about their disease and the appropriate treatment and feel able to treat themselves within the scope of self-medication. Nevertheless, they mostly respond to one triptan only. In the case of an acute migraine attack an immediate treatment is required, ideal is an intake of triptans as soon as first symptoms occur. In this context pharmacies play an important role as fast and low-threshold access point to medications. Because only a limited number of patients responds to the already prescription free available triptans, there is a demand for further Rx-to-OTC switches of triptans among migraine patients which should be considered in further switch efforts in Germany.

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Aktuelle Diagnostik und Therapie der Migräne

Cited by 6 publications

References 63 publications

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

Mythos Migräne

The treatment of migraine patients with triptans – is there a need for further Rx-to-OTC switches?

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