Prescription migraine medicine
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Prescription Migraine Medicine: An Overview
Acute Migraine Treatment: Triptans and NSAIDs
Triptans are a cornerstone in the acute treatment of migraines. Medications such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan have been shown to be highly effective in alleviating migraine symptoms1. These drugs work by targeting serotonin receptors, which helps to reduce inflammation and constrict blood vessels, thereby alleviating headache pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, diclofenac, ibuprofen, and naproxen, are also commonly prescribed for acute migraine relief. These medications help reduce inflammation and pain1. High-dose aspirin (900 to 1300 milligrams) has been found to be an effective and safe option for treating acute migraine attacks5.
Preventive Migraine Medications
Preventive treatments aim to reduce the frequency and severity of migraine attacks. Erenumab, galcanezumab, and ubrogepant are newer medications that have shown promise in preventing migraines by targeting specific pathways involved in migraine pathogenesis3. These drugs can significantly reduce the number of migraine days and improve the quality of life for sufferers.
Traditional Chinese Medicine (TCM) for Migraine
Chuanxiong Chatiao San (CXCT) is a traditional Chinese prescription that has been found to be effective in treating migraines, especially when combined with Western conventional medicine (WCM). Studies have shown that CXCT can significantly reduce the number of migraine episodes, headache duration, and adverse events compared to WCM alone2. Other TCM prescriptions like Da Chuan Xiong Formula (DCXF) and Tian Ma Gou Teng Decoction (TMGTD) are also used to treat migraines by addressing both symptoms and root causes4.
Prescription Patterns and Usage
A study examining prescription patterns revealed that NSAIDs are more frequently prescribed than triptans for acute migraine treatment. This may be due to the broader availability and lower cost of NSAIDs6. However, triptans remain a popular choice among those who have access to them, with many patients reporting significant relief from their use7.
Conclusion
The treatment of migraines involves a variety of pharmacological options, each with its own benefits and limitations. Triptans and NSAIDs are effective for acute treatment, while newer preventive medications like erenumab and galcanezumab offer promising results for reducing migraine frequency. Traditional Chinese Medicine also provides alternative options that can be used alone or in combination with Western medicine. Understanding the efficacy and safety profiles of these treatments can help clinicians tailor therapy to individual patient needs, improving outcomes and quality of life for migraine sufferers.
Sources and full results
Most relevant research papers on this topic
The Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies
Many acute migraine treatments have evidence supporting their efficacy, including triptans, dihydroergotamine, and various nonspecific medications.
Systematic Review
Rigorous Journal
Highly CitedA Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
CXCT and CXCT combined with Western conventional medicine have higher efficacy in treating migraine compared to Western medicine alone.
Meta-AnalysisRigorous JournalEfficacy of Different Drugs for Migraine Treatment
Dexketoprofen, galcanenzuma, Erenumab, TV-48125, Gapant, and losmiditan show promising results in reducing migraine pain and reducing agony days.
Progress in Traditional Chinese Medicine for the Treatment of Migraine.
Traditional Chinese medicine (TCM) effectively treats migraine symptoms and root causes, avoiding side effects and offering multiple treatment strategies.
Aspirin in the Treatment and Prevention of Migraine Headaches: Possible Additional Clinical Options for Primary Healthcare Providers.
Aspirin, in high doses, is an effective and safe treatment for acute migraine headaches and may be an effective and safe prevention option for recurrent migraine headaches.
Prescription patterns in preventive and abortive migraine medication
Preventive migraine medication use is high, but acute treatment patterns show NSAIDS use more often than triptans, with national guidelines not reflecting prescription patterns up to 2006.
Observational StudyCharacterization of Acute Prescription Migraine Medication Use: Results From the CaMEO Study.
Many people with migraine have never used acute prescription migraine medication, despite experiencing moderate to severe disability and impairment.
Observational StudyMigraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action
Acute migraine medications aim to rapidly restore function with minimal recurrence and avoid side effects, with individualized treatment choices based on attack characteristics, patient preferences, and drug properties.
Very Rigorous JournalHighly Cited[Selection principles and analysis of common prescriptions in clinical practice guidelines of traditional Chinese medicine--case example of migraine].
Chuanxiong Rhizoma and Angelicae Dahuricae Radix are the most common prescriptions for migraine treatment, with external wind syndrome, blood stasis, and brain blocking being common syndrome types.
Observational StudyHejie Zhitong prescription promotes sleep and inhibits nociceptive transmission-associated neurotransmitter activity in a rodent migraine model
Hejie Zhitong prescription promotes sleep and inhibits pain transmission-related neurotransmitters, potentially improving migraine treatment by upregulating CB1R and downregulating COX-2.
RCT
Animal Study