Pharmacologic management of migraine—19851
Robert S. Kunkel, M.D.
Head, Section of Headache, Department of Internal Medicine, The Cleveland Clinic Foundation, Cleveland OH 44106
There are many pharmacologic agents available for treating patients with migraine. One must first decide whether daily prophylactic medication or intermittent acute abortive therapy is indicated. New agents are available for both prophylactic and abortive treatments. Metoclopramide, an antinauseant, has proved to be a useful adjunct in managing acute migrainous attacks. Beta blockers and the new calcium channel antagonists can control the number and severity of attacks in many patients. The anti-inflammatory agents are being used extensively for both migraine and chronic muscle contraction headache. This review focuses on the pharmacologic actions and optimum use of medications in the migraine patient.