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The main difference between the two is that cluster headaches tend to occur in cycles, while many patients with migraines have headaches for a few days in a row once a month, Collins said.
Rescue treatment involves acute symptomatic control with medication. [4] Recommendations for rescue therapy of migraine include: (1) migraine-specific agents such as triptans, CGRP antagonists, or ditans for patients with severe headaches or for headaches that respond poorly to analgesics, (2) non-oral (typically nasal or injection) route of administration for patients with vomiting, (3) avoid ...
The drugs are started at a low dose, which is gradually increased until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or side effects become intolerable. Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. [ 11 ]
Methysergide is used exclusively to treat episodic and chronic migraine and for episodic and chronic cluster headaches. [12] Methysergide is one of the most effective [13] medications for the prevention of migraine, but is not intended for the treatment of an acute attack, it is to be taken daily as a preventative medication.
The drugs of this class act as agonists for serotonin 5-HT 1B and 5-HT 1D receptors at blood vessels and nerve endings in the brain. The first clinically available triptan was sumatriptan, which has been marketed since 1991. Triptans have largely replaced ergotamines, an older class of medications used to relieve migraine and cluster headaches. [3]
While pizotifen is effective in adults, [2] evidence of efficacy in children is limited, [3] and its use is limited by side effects, principally drowsiness and weight gain, and it is usually not the first choice medicine for preventing migraines, instead being used as an alternative when other drugs have failed to be effective. [4]
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