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Treatment of migraine in the emergency department
Author(s) -
Hunter Gary,
TéllezZenteno José F.
Publication year - 2007
Publication title -
drug development research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.582
H-Index - 60
eISSN - 1098-2299
pISSN - 0272-4391
DOI - 10.1002/ddr.20202
Subject(s) - migraine , sumatriptan , medicine , photophobia , dihydroergotamine , triptans , nausea , metoclopramide , migraine treatment , anesthesia , adverse effect , acute migraine , headaches , emergency department , intensive care medicine , vomiting , alternative medicine , surgery , psychiatry , agonist , placebo , receptor , pathology
Migraine is defined as a severe, episodic, unilateral, throbbing headache accompanied by nausea, photophobia, visual symptoms, and neurological manifestations. The goal of acute migraine treatment is to ensure a prompt cessation of pain and associated symptoms and resumption of normal activity. Additional considerations include minimizing adverse effects and cost of therapy. As for all neurological patients, a careful history is the first and most critical step in diagnosis and management. For many years, NSAIDs and dihydroergotamine were the main medications used to treat migraine in the emergency setting. In 1993, sumatriptan was introduced as an effective medication to treat migraine. Since then a generation of medications mechanistically similar to sumatriptan have been introduced that show notable benefits in the treatment of migraine. Over the years, other treatments have been introduced including dexamethasone, magnesium, and metoclopramide. In this article, we review the best evidence regarding the acute treatment of migraine, describing major advances and the conventional drugs that remain as effective treatments. Drug Dev Res 68:360–368, 2007. © 2007 Wiley‐Liss, Inc.