Prophylaxis of migraine

Abstract

Migraine is a common primary headache disorder often associated with significant disability. While many individuals are able to limit therapy to acute treatment of attacks, others need medication to reduce the attack frequency and/or severity. Evidence-based guidelines exist regarding indications and goals for migraine preventive treatment. The specific prophylactic approach needs to be individualized taking into account multiple variables. Medications used in this task vary widely in proven efficacy and presumed mechanisms of action. This review’s goal is to discuss the issues that guide the decision-making process in migraine preventive treatment.

Quality of Life of Migraine Patients Treated With Combined Propranolol and Topiramate

“…A randomized, double-blind, placebo-controlled multicenter trial on the effect of administering topiramate on HRQOL also showed that topiramate significantly improved mean SF36-RP domain scores vs. placebo after treatment, and patients had improved SF36-VT domain scores, although not significantly compared to placebo which was similar to our study (20). Vitality did not changed significantly after treatment of MP, maybe due to fatigue as complications of topiramate and propranolol (7).…”

“…Treatments could reduce frequency and pain severity of migraine, which consequently can decrease the medical cost and burden of disease (6). Appropriate medical management for MP varies as acute, prophylactic, or both, and best approach is chosen according to the clinical setting (7). Many of MPs only need treatments for acute attacks but others need prophylactic treatment; indications for prophylactic treatment are present elsewhere (7,8).…”

“…Appropriate medical management for MP varies as acute, prophylactic, or both, and best approach is chosen according to the clinical setting (7). Many of MPs only need treatments for acute attacks but others need prophylactic treatment; indications for prophylactic treatment are present elsewhere (7,8). Appropriate prophylaxis is important for reducing disability and preventing progression of the disease into a chronic progressive illness (9).…”

The Importance of Medicinal Chemistry Knowledge in the Clinical Pharmacist’s Education

“…Patients previously diagnosed with asthma, chronic obstructive pulmonary disease (COPD) and other bronchoreactivity-related conditions should not use these drugs. 13 In counterpart, the b 2 receptors blockade may be useful in treating migraine, 15 since the b 2 receptors located in brain vessels are involved in vasodilation. The AbR are also found in the central nervous system (CNS), where they are involved in mood regulation.…”

Migraine ? a suitable case for treatment?

“…In this issue of Neuropsychiatric Disease and Treatment, all three approaches to migraine management are reviewed. Garza and Swanson (2006) review the prophylaxis of migraine, an approach to be considered whenever migraine significantly interferes with the patient’s daily activities despite acute treatment, when acute treatments have failed, are overdosed or are associated with adverse effects, and where rare migraine conditions can potentially cause neurological damage. Evidence-based guidelines have stated the goals for preventive treatment to be (1) to reduce attack frequency, severity, and duration; (2) to improve responsiveness to treatment of acute attacks; and (3) to improve function and reduce disability.…”