Pharmacologic Management of Acute Attacks of Migraine and Prevention of Migraine Headache

The document provided guidelines for managing acute migraine attacks and preventing migraine headaches, emphasizing individualized treatment plans and patient involvement. For acute attacks, NSAIDs and triptans were recommended as first-line treatments, while ergotamines and opioids were less favored due to effectiveness and adverse effects. Preventive treatments included β-blockers, antidepressants, and anticonvulsants, with propranolol, timolol, and amitriptyline showing consistent efficacy. The guidelines also stressed avoiding medication-overuse headaches and suggested preventive therapy for patients with frequent or severe migraines. The evidence for many treatments was limited or inconclusive, indicating a need for further research.