A REVIEW OF THE TREATMENT OF PRIMARY HEADACHES .1. MIGRAINE

Finding the best treatment for a patient's migraine is often a problem in clinical practice since the condition is very common, often debili tating and may prove refractory to therapy. Over recent years, more ef fective migraine treatments have been found and validated and the trad itional remedies have undergone controlled testing. This article revie ws the various therapies available for both the acute treatment and pr evention of migraine. Treatments often effective against migraine atta cks are: aspirin, analgesics, non steroid anti-inflammatory drugs (NSA IDs), ergot derivatives and sumatriptan. Five main classes of prophyla ctic drug are currently used: beta-blockers, calcium antagonists, sero tonin modulators, NSAIDs and ergot compounds. Biofeedback, one of the most efficacious non-pharmacological preventive treatments of migraine , is also discussed. The variables influencing the choice of acute and preventive treatments, including contraindications and drug availabil ity, are also described in order to provide a practical and up-to-date guide to migraine therapy.