Drugs Useful in the Treatment and Prophylaxis of Migraine Headaches

Several classes of drugs are effective in reducing the frequency and severity of migraine attacks:

 • ß-Blockers: Propranolol and nadolol.

 • Tricyclic antidepressant: Amitriptyline

 • Anticonvulsant: Divalproex

 • Calcium channel blocker: Verapamil

TRIPTANS

 • Triptans rapidly and effectively abort or markedly reduce the severity of migraine headaches in about 80% of patients.

 • Triptans are serotonin agonists, acting at 5-HT1D receptors.

DIHYDROERGOTAMINE

 • Dihydroergotamine is a vasoconstrictor.

 • Most effective when given during the prodromal phase.

 • Contraindicated in pregnancy and in patients with peripheral vascular disease or coronary artery disease.

ANALGESICS

 • Anti-inflammatory drugs, such as aspirin, naproxen, and ibuprofen, are useful in relieving migraine attacks.

 • Severe pain may require administration of opioids, such as codeine sulfate or meperidine.



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