THERAPY OF ACUTE MIGRAINE ATTACKS AND MIG RAINE PROPHYLAXIS - GUIDELINES OF THE GERMAN-MIGRAINE-AND-HEADACHE-SOCIETY

Mild migraine attacks are treated with antiemetics combined with ergot amine. Sumatriptan is used if attacks do not respond to ergotamine or if untolerable side effects occur. Migraine prophylaxis should be impl emented when more than 3 attacks occur per month, if attacks do not re spond to attack treatment or if side effects of acute treatment are se vere. Substances with proven efficacy are the beta-blockers metoprolol and propranolol and flunarizine. Drugs with possible efficacy are the 5-HT-antagonists (pizotifen, methysergide and lisuride), dihydroergot amine, cyclandelate, non-steroidal antiinflammatory drugs, acetylsalic ylic acid and valproic acid. Non medical prophylaxis includes advice a nd counceling, exercise, muscle relaxation therapy, stress coping and cognitive-behavioral therapy.