Sammanfattning
Aim:
This article gives an overview of available drugs recommended for acute and preventive
pharmacological treatment of migraine, with special focus on documented effect, and provides
recommendations for use of anti-migraine medications in practice.
Material and methods:
The review is based on a qualified selection of relevant literature found by searching the Medline
database, in addition to Norwegian and international treatment guidelines for migraine treatment.
Individual product monographs were also consulted.
Results:
Effective first-line treatment options of acute migraine attacks include paracetamol, acetyl-salicylic
acid, NSAIDs and triptans. Various administration forms are available. Frequent use of such
medications increases the risk of medication overuse headache. For patients experiencing nausea
and vomiting, metoclopramide is the recommended antiemetic of choice. Propranolol, metoprolol,
valproate, topiramate and candesartan have the best evidence of efficacy in migraine prophylaxis.
Conclusion:
There are currently many effective anti-migraine drugs available, making it possible to provide
tailored treatment for individual patients. Pharmacists have an important role in patient education of
drug use for migraine, and may identify patients at risk of medication overuse. Patients using acute
anti-migraine agents more frequently than recommended should be encouraged to discuss the
option of preventive treatment with their doctor.