OVERVIEW OF DIAGNOSIS AND TREATMENT OF MIGRAINE

Optimal migraine therapy begins with an accurate diagnosis and knowled ge of the symptoms that the patient finds most disturbing. Pharmacolog ic treatment of migraine may be acute (abortive, symptomatic) or preve ntive (prophylactic); both approaches are frequently required in patie nts with frequent, severe headaches. Drugs for acute care consist of a nalgesics, antiemetics, anxiolytics, nonsteroidal anti-inflammatory dr ugs, ergots, steroids, major tranquilizers, narcotics, and selective s erotonin agonists. Preventive agents include beta-blockers, calcium ch annel blockers, antidepressants, serotonin antagonists, and anticonvul sants. The choice of a preventive drug depends on side effect profiles and comorbid conditions. Behavioral interventions, such as biofeedbac k and relaxation techniques, are an important complement to pharmacolo gic therapy; however, drugs are the mainstay of migraine therapy. To e nsure that therapy achieves optimal results, the individual patient's preferred approach to this debilitating problem must be considered car efully.