CURRENT APPROACHES TO THE PROPHYLAXIS OF MIGRAINE

Migraine is a prevalent and often debilitating condition. Because of t his, effective prophylaxis to prevent the recurrence of attacks is an advantageous approach to therapy for some patients. Five main classes of prophylactic agents are currently employed: beta-blockers, calcium antagonists, serotonin (5-hydroxytryptamine; 5-HT) modulators, non-ste roidal anti-inflammatory drugs and ergot alkaloids. Many variables inf luence the choice of therapy, including the different characteristics of the available drugs and of each patient. Although beta-blockers and flunarizine are generally the most effective prophylactic agents, the re is no drug of first-choice and the agent chosen must be carefully t ailored to the needs of the individual patient. Status migrainosus - p rolonged unresponsive migraine attacks - requires, in most patients, a specific administration protocol consisting of dihydroergotamine, ste roids and phenothiazines.