Migraine - Treatment

Treatment in acute phaseIn patients with migraine pain occurs slowly which can be given aspirin or acetaminophen, ibuprofen (600-800mg) or naproxen (375-750 mg).In common migraine are mild or moderate izometepten effective compounds (1-2 capsules). If these measures do not work more aggressive therapy is applied as follows:
- Time to reach maximum pain> 3 hours, the first therapeutic option is ergotamine in doses of 2-3 tablets, the second option is 1-2 tablets izometepten compound, the third option is combination with aspirin or acetaminophen butalbital 1-2 tablets
- Time to reach maximum pain within 1-3 hours, the first therapeutic option is a dose dihydroergotamine nasal spray (2 mg), the second option is half ergotamine suppositories, a third option sumatriptan tablets (25-50 mg)
- Time to reach maximum pain <1 hour, the first option is sumatriptan 6 mg sc, the second option dihydroergotamine 1mg IM or s.c., the third option 1-2 mg butorphanol nasalIf the headache is a chronic amitriptyline is given daily 30-100mg or 120mg notriptilina 40th, and if the pain does not give is given valproic acid 500-2000mg or phenelzine 45-90mg.
 Migraine PreventionApply at least 2-3 if you are having seizures per month.Drugs most commonly used are:- Amitriptyline 10-175mg/zi. Side effects: dry mouth, weight gain- Propranolol 60-320mg/zi- 500-1500mg/zi valproic acid. Side effects: nausea, tremor, weight gain, hair loss- Verapamil 160-480mg/zi. Side effects: constipation, nausea, dizziness, hypotension- 30-75mg/zi phenelzine. Side effects: insomnia, dizziness, difficult urination, weight gain. Bring in recalcitrant cases.- Metisergid 2-8mg/zi. Side effects include nausea, cramps, insomnia, weight gain, peripheral vasoconstriction, the use of retroperitoneal fibrosis over 6 months.On getting to stabilize the product lasts 5-6 months and then gradually decrease the dose.Nonpharmacologic methodsAvoid stressful events as much as possible, practicing the methods of relaxation, walking, socialization, conditioning techniques such as bio-feedback. They have a role in adjuvant pharmacotherapy.