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For patients who require preventive therapy with symptoms such as more than 4 migraines per month or migraines lasting longer than 12 hours, first-line drugs for the prevention of migraine attacks include beta blockers, antidepressants, and anti convulsants.
Atogepant demonstrated efficacy in two phase 3 trials (ADVANCE and PROGRESS) by significantly reducing monthly migraine days, acute medication use, and improving quality of life in patients with episodic and chronic migraine over 12 weeks compared to placebo. [13] Common side effects included nausea, constipation, and fatigue/somnolence.
Rimegepant, sold under the brand name Nurtec ODT among others, is a medication used for the acute treatment of migraine with or without aura in adults and the prophylactic/ preventive treatment of episodic migraine in adults. [8] [10] It is taken by mouth to dissolve on or under the tongue. [8] It works by blocking CGRP receptors. [11]
Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. They are selective 5-hydroxytryptamine/serotonin 1B/1D (5-HT 1B/1D) agonists. [1] Migraine is a complex disease which affects about 15% of the population and can be highly disabling. [2]
Ubrogepant, sold under the brand name Ubrelvy, is a medication used for the acute (immediate) treatment of migraine with or without aura (a sensory phenomenon or visual disturbance) in adults. [4] [5] It is not indicated for the preventive treatment of migraine. [6] Ubrogepant is a small-molecule calcitonin gene-related peptide receptor antagonist.
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 ...
Sumatriptan is effective for ending or relieving the intensity of migraine and cluster headaches. [9] It is most effective when taken early after the start of the pain. [9] Injected sumatriptan is more effective than other formulations. [10] Oral sumatriptan can be used also in the treatment of post-dural puncture headache. [11]
Pizotifen has also been reported as highly effective in a severe case of erythromelalgia, a rare neurovascular disease that is sometimes refractory to the other drugs named above. [ 5 ] Other applications for which pizotifen may be used include as an antidepressant , or for the treatment of anxiety or social phobia .
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