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Migraine: diagnosis, management, and new treatment options.
Am J Manag Care. 2002 Feb; 8(3 Suppl):S58-73.AJ

Abstract

OBJECTIVE

The safety and tolerability of medications used to treat acute migraine attacks are summarized, the classification of headaches and the causes of and diagnostic criteria for migraine are reviewed, and the clinical tolerability profiles and therapeutic benefits of second-generation triptans are presented.

BACKGROUND

Migraine is a paroxysmal disorder characterized by attacks of headache, nausea, vomiting, photophobia, and phonophobia. Drugs used to prevent migraine and those that effectively treat acute migraine attacks are readily available.

METHODS

Mild or moderate migraines are often treated with aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, antiemetic drugs, or isometheptene. Triptans (5-HT1 receptor agonists) are used to treat moderate or severe migraine and when nonspecific medications have been ineffective. Because sumatriptan, the first triptan used, is effective but can induce adverse events, second-generation triptans (zolmitriptan, naratriptan, rizatriptan, and almotriptan) were developed to increase the benefit-to-risk ratio in migraine management.

RESULTS

Important pharmacologic, pharmacokinetic, and clinical differences exist among those drugs, but the tolerability profile of the newer triptans is very good, and they provide rapid relief from headache and sustained duration of effect.

CONCLUSION

Primary care physicians must manage migraine patients with treatments that demonstrate a balance between efficacy and tolerability.

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Authors+Show Affiliations

Gallagher RM
University of Medicne and Dentistry of New Jersey, School of Medicine, Stratford, USA.
Cutrer FM
No affiliation info available

MeSH

AnalgesicsHumansMigraine DisordersSerotonin Receptor AgonistsUnited States

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11859906

Citation

Gallagher, R Michael, and F Michael Cutrer. "Migraine: Diagnosis, Management, and New Treatment Options." The American Journal of Managed Care, vol. 8, no. 3 Suppl, 2002, pp. S58-73.
Gallagher RM, Cutrer FM. Migraine: diagnosis, management, and new treatment options. Am J Manag Care. 2002;8(3 Suppl):S58-73.
Gallagher, R. M., & Cutrer, F. M. (2002). Migraine: diagnosis, management, and new treatment options. The American Journal of Managed Care, 8(3 Suppl), S58-73.
Gallagher RM, Cutrer FM. Migraine: Diagnosis, Management, and New Treatment Options. Am J Manag Care. 2002;8(3 Suppl):S58-73. PubMed PMID: 11859906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Migraine: diagnosis, management, and new treatment options. AU - Gallagher,R Michael, AU - Cutrer,F Michael, PY - 2002/2/28/pubmed PY - 2002/3/15/medline PY - 2002/2/28/entrez SP - S58 EP - 73 JF - The American journal of managed care JO - Am J Manag Care VL - 8 IS - 3 Suppl N2 - OBJECTIVE: The safety and tolerability of medications used to treat acute migraine attacks are summarized, the classification of headaches and the causes of and diagnostic criteria for migraine are reviewed, and the clinical tolerability profiles and therapeutic benefits of second-generation triptans are presented. BACKGROUND: Migraine is a paroxysmal disorder characterized by attacks of headache, nausea, vomiting, photophobia, and phonophobia. Drugs used to prevent migraine and those that effectively treat acute migraine attacks are readily available. METHODS: Mild or moderate migraines are often treated with aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, antiemetic drugs, or isometheptene. Triptans (5-HT1 receptor agonists) are used to treat moderate or severe migraine and when nonspecific medications have been ineffective. Because sumatriptan, the first triptan used, is effective but can induce adverse events, second-generation triptans (zolmitriptan, naratriptan, rizatriptan, and almotriptan) were developed to increase the benefit-to-risk ratio in migraine management. RESULTS: Important pharmacologic, pharmacokinetic, and clinical differences exist among those drugs, but the tolerability profile of the newer triptans is very good, and they provide rapid relief from headache and sustained duration of effect. CONCLUSION: Primary care physicians must manage migraine patients with treatments that demonstrate a balance between efficacy and tolerability. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/11859906/Migraine:_diagnosis_management_and_new_treatment_options_ L2 - https://www.ajmc.com/pubMed.php?pii=363 DB - PRIME DP - Unbound Medicine ER -