Migraine Treatment Options

It is advised that users of this website consult their local treatment guidelines before initiating any treatment programme for a patient with migraine.

Once migraine is diagnosed, patients and physicians should decide together how best to treat acute attacks and whether to use preventive medications.

• When choosing treatment, the frequency and severity of attacks, the presence and degree of temporary disability, and associated symptoms such as nausea and vomiting should be considered.
• As the majority of migraineurs have used a number of over-the-counter medications,^[1] their treatment history and response to and tolerance of specific medications should be considered.
• Co-existing conditions (such as heart disease, pregnancy or uncontrolled hypertension) may limit treatment options.
• Patient preference for, and satisfaction with, migraine medications is important to the success of treatment. In evaluations of patients’ views of migraine medications, patients state that they want:^[2]
  •  greater speed of action
  • enhanced overall effectiveness
  • restored ability to function
  • fewer side effects
  • greater overall satisfaction with therapy
  • convenient formulations that may better suit their lifestyle.

The Migraine and Zolmitriptan Evaluation (MAZE) survey demonstrated that migraine sufferers want drugs that work quickly, are effective, and can be taken anywhere.^[3] Indeed, treatment guidelines now identify patient preference as a key factor in the choice of an appropriate migraine medication, with patients requiring therapies that are effective as well as practical and easy to use.^[2]

References:
1. MacGregor EA, Brandes J, Gendolla A, Giammarco R. Migraine treatment strategies: the global Migraine And Zolmitriptan Evaluation (MAZE) survey--phase IV. Curr Med Res Opin 2004;20: 1777-83.
2. Migraine in Primary Care Advisors (MIPCA). MIPCA guidelines for the management of migraine. 2003. (Accessed 21 August, 2007, at http://www.mipca.org.uk/pdf/newsletters/NL6_Nurse.pdf.)
3. MacGregor EA, Brandes J, Eikermann A. Migraine prevalence and treatment patterns: the global Migraine and Zolmitriptan Evaluation survey. Headache 2003;43: 19-26.