Lipton RB, 564 0 obj <> endobj xref 564 73 0000000016 00000 n Nicardipine (Cardene) is classified as possibly effective. Winters ME.

0000010532 00000 n Burch R, Sheikh H, Mulleners WM, Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society [published correction appears in Loder E, Propranolol has been compared with placebo in about 60 trials; in data pooled from nine of these studies, the calculated responder ratio (comparable to Headaches rank among the top five reasons for emergency department visits and top 20 reasons for outpatient visits.Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms).Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment.Petasites has been established as effective and can be considered for migraine prevention.Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention.Adding acupuncture to symptomatic treatment decreases the frequency of migraine headaches.Preventive therapy should be considered in patients having four or more headaches a month or at least eight headache days a month, significantly debilitating attacks despite appropriate acute management, difficulty tolerating or having a contraindication to acute therapy, medication overuse headache, patient preference, or the presence of certain migraine subtypes (i.e., hemiplegic migraine; migraine with brainstem aura; migrainous infarction; or frequent, persistent, or uncomfortable aura symptoms).Divalproex (Depakote), topiramate (Topamax), metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered as first-line treatment.Petasites has been established as effective and can be considered for migraine prevention.Behavioral treatments, such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic biofeedback, and cognitive behavior therapy, are effective options for migraine prevention.Adding acupuncture to symptomatic treatment decreases the frequency of migraine headaches.Migraines are distinguished from other headache types by the following attributes: lasting four to 72 hours; unilateral location; pulsating quality; moderate to severe intensity; aggravated by physical activity; and associations with nausea, vomiting, phonophobia, or photophobia.

0000012245 00000 n Nebivolol and metoprolol for treating migraine: an advance on beta-blocker treatment? Ashwal S, et al. Believed by the patient to be migraine at onset and relieved by triptan or ergot derivativeHeadache occurring on at least 15 days per month in a patient with a pre-existing headache disorderRegular overuse for more than three months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache††—Regular intake of ergotamine, triptan, or opioid medications for a total of at least 10 days per month or nonopioid medications (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs) for at least 15 days per month.At least five attacks fulfilling criteria B, C, and DAttack lasting 4 to 72 hours (untreated or unsuccessfully treated)Having at least two of these characteristics: aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs), moderate or severe pain intensity, pulsating quality, unilateral locationHaving at least one of these conditions during the headache: nausea and/or vomiting, phonophobia or photophobiaHaving one or more of these fully reversible aura symptoms: brainstem, motor, retinal, sensory, speech and/or language, visualHaving at least two of these characteristics: at least one aura symptom spreads gradually over at least 5 minutes and/or two or more symptoms occur in succession; each individual aura symptom lasts 5 to 60 minutes; at least one aura symptom is unilateral; the aura is accompanied or followed within 60 minutes by headacheCharacterized by those with migraine who have zero to 14 headache days per monthHeadaches at least 15 days per month for more than 3 months and fulfilling criteria B and COccurring in patients with at least five attacks fulfilling criteria in the Migraine with Aura or Migraine without Aura sectionsFor at least 8 days per month for more than 3 months, fulfills any of the following: Feuersenger A, 0000021473 00000 n 0000052343 00000 n In past guidelines, verapamil and nimodipine (Nimotop) were originally considered effective for migraine prophylaxis. Schrader H, Avoid agents that are contraindicated or that may exacerbate coexisting conditions Start with the lowest effective dose and titrate every two to four weeks until therapeutic effect or until patient develops adverse effects Set realistic goals. Modi S,

Burch R, Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Schellenberg R, Venlafaxine versus amitriptyline in the prophylactic treatment of migraine: randomized, double-blind, crossover study. The International Classification of Headache Disorders, 3rd edition. Argoff C, McCrory DC. 0000008158 00000 n