Abortive Migraine Therapy

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Abortive Migraine Therapy

Abortive migraine therapy is an integral part of the management of migraine patients, designed to prevent or reduce attack frequency and severity, relieve pain and other symptoms, and enhance quality of life for those affected by migraines. Additionally, it may help control or reverse existing migraine progression.

Treatments for migraine usually consist of a combination of medication and nonpharmacologic therapies. These may include analgesics, antidepressants, antiemetics, calcitonin gene-related peptide (CGRP) antagonists, as well as noninvasive neuromodulation devices when other pharmacologic or nonpharmacologic interventions do not provide enough relief.

Acetaminophen and ibuprofen can be effective in treating mild to moderate migraines. Other treatments include combination painkillers, triptans, and ergot alkaloids such as dihydroergotamine or lasmiditan.

Multiple studies have supported the use of nonsteroidal anti-inflammatories (NSAIDs) as an effective migraine treatment. One trial found powdered diclofenac potassium (50 mg) produced faster pain relief at two hours than tablets did, and another trial found indomethacin suppositories (50 mg) more effective at relieving migraine symptoms than oral medications or placebo.

Combination ergot alkaloids such as lasmiditan and dihydroergotamine are effective treatments for severe recurrent headaches. They may be administered orally, via nasal spray, or injection; however, studies have demonstrated that these drugs work best when taken within 15 minutes of onset and when pain is mild.

Other effective treatments for abortive migraines have included intravenous (IV) valproate, metoclopramide and ketorolac, which can be given individually or combined. These drugs can be given in the emergency department or clinic setting and are safer alternatives than IV opiates like hydromorphone which may lead to liver failure and death.

Opioids are often prescribed as the first-line therapy for acute migraine in emergency rooms, despite their increased risk of headache recurrence and potential cardiovascular risks such as heart rhythm issues, stroke or other cardiovascular issues.

For most patients suffering from migraine, simple analgesics such as acetaminophen, ibuprofen or aspirin provide enough relief of pain and other symptoms. In more serious cases of chronic migraine, NSAIDs in combination with acetaminophen or triptans may be prescribed.

Triptans are antimigraine drugs that block pain signals in the brain and may be effective at relieving recurrent headaches. They’re often prescribed for people suffering from severe cases of migraine or cluster headaches that occur frequently.

The American Headache Society recommends that triptans be administered within 15 minutes of experiencing headache, with pain and other symptoms reduced to mild or no discomfort after two hours. Triptans should be discontinued if they fail to provide satisfactory relief within four weeks or symptoms return.

In addition to NSAIDs, triptans, and other drugs, migraine patients should be assessed for cardiovascular risks. Smokers should be counseled on the increased risk of stroke associated with smoking; those with high blood pressure, abnormal cholesterol levels or family history of heart disease should be observed closely for changes in pulse and blood pressure.

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- Welcome, SoundTherapy.com lowers anxiety 86%, pain 77%, and boosts memory 11-29%. Click on the brain to sign up or share with buttons below to help others: