Modern Management of the Migraine Headache
Kimberly A. Pesaturo, PharmD; Fae G. Wooding, PharmD
Abstract
Migraine headache is a debilitating disorder that affects millions of people in the United States and worldwide. The diagnosis of migraine can significantly affect quality of life, health care costs, and daily productivity. Hundreds of trials and many guidelines have documented various approaches to migraine management, whether via acute treatment or chronic migraine prophylaxis. Acute or abortive migraine managementencompasses specific and nonspecific migraine therapeutics, including nonopioid and opioid analgesics, triptans, and ergotamines. Prophylactic migraine management data span the pharmacological spectrum from antiepileptic and antihypertensive agents to botulinum toxin type A. Special considerations for migraine management also must be applied in various populations, including children, pregnant women, and the elderly. The following review serves as an introduction to current therapeutic approaches for acute migraine treatment and provides an overview of available literature for pharmacological prophylaxis.
Migraine headache is a debilitating disorder that affects millions of people in the United States and worldwide. The diagnosis of migraine can significantly affect quality of life, health care costs, and daily productivity. Hundreds of trials and many guidelines have documented various approaches to migraine management, whether via acute treatment or chronic migraine prophylaxis. Acute or abortive migraine managementencompasses specific and nonspecific migraine therapeutics, including nonopioid and opioid analgesics, triptans, and ergotamines. Prophylactic migraine management data span the pharmacological spectrum from antiepileptic and antihypertensive agents to botulinum toxin type A. Special considerations for migraine management also must be applied in various populations, including children, pregnant women, and the elderly. The following review serves as an introduction to current therapeutic approaches for acute migraine treatment and provides an overview of available literature for pharmacological prophylaxis.
Introduction
Over the past 2 decades, an increase in migraine awareness has resulted in the introduction of new pharmacological treatment agents as well as additional indications and data on existing medications for prophylaxis. Migraine is defined as a unilateral headache with pulsating pain of a moderate to severe intensity, often accompanied by photophobia, phonophobia, and/or nausea, and may occur with or without aura.[1] The headaches exhibit a recurrent pattern and can
significantly affect activities of daily living. Approximately 30 million people in the United States suffer from migraines, with 18% of women and 6% of men experiencing at least 1 migraine headache annually. [1]
Because of its significant impact on quality of life and interpatient variability in treatment response, migraine management remains challenging for many health care professionals. Migraine has a significant societal burden resulting in costly medical bills and lost productivity, averaging about 64 to 150 million work days lost each year.[2,3] Consequently , migraine headache has been classified by the World Health Organization as one of the 19 most disabling diseases worldwide .[4] Migraine prevalence varies by age, sex, and ethnicity with the highest prevalence in whites, followed by African Americans and then Asians.[5] In the United States, the prevalence of migraine headache decreases as household income increases.[6] Although hundreds of clinical trials are available regarding migraine treatment modalities, this review serves as an introduction to current accepted therapeutics for migraine treatment and an overview of pharmacological prophylaxis in the modern management of migraine.
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Over the past 2 decades, an increase in migraine awareness has resulted in the introduction of new pharmacological treatment agents as well as additional indications and data on existing medications for prophylaxis. Migraine is defined as a unilateral headache with pulsating pain of a moderate to severe intensity, often accompanied by photophobia, phonophobia, and/or nausea, and may occur with or without aura.[1] The headaches exhibit a recurrent pattern and can
significantly affect activities of daily living. Approximately 30 million people in the United States suffer from migraines, with 18% of women and 6% of men experiencing at least 1 migraine headache annually. [1]
Because of its significant impact on quality of life and interpatient variability in treatment response, migraine management remains challenging for many health care professionals. Migraine has a significant societal burden resulting in costly medical bills and lost productivity, averaging about 64 to 150 million work days lost each year.[2,3] Consequently , migraine headache has been classified by the World Health Organization as one of the 19 most disabling diseases worldwide .[4] Migraine prevalence varies by age, sex, and ethnicity with the highest prevalence in whites, followed by African Americans and then Asians.[5] In the United States, the prevalence of migraine headache decreases as household income increases.[6] Although hundreds of clinical trials are available regarding migraine treatment modalities, this review serves as an introduction to current accepted therapeutics for migraine treatment and an overview of pharmacological prophylaxis in the modern management of migraine.
DOWNLOAD COMPLETE PDF HERE
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