Interim results of a prospective, randomized, open-label, Phase 3 study of the long-term safety and efficacy of lasmiditan for acute treatment of migraine (the GLADIATOR study). : Janssen Pharmaceuticals, Inc., Titusville, NJ. Durham PL, Garrett FG. Forsyth PA, Posner JB. Multiple spotty scotomata are described by a person who experiences migraines. Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Pharmacologic management of migraine includes abortive/ acute therapy (eg, treating the HA during premonitory or HA phases), and prevention therapy (eg, treatments for preventing migraine attacks). Abortive Medication Stratification by Headache Severity April 24, 2018. Tornabene SV, Deutsch R, Davis DP, Chan TC, Vilke GM. Role of magnesium in the pathogenesis and treatment of migraine.
Two devices now have FDA approval and are available in the United States with a prescription:Which medications or devices are part of our regimen depends upon us and our Migraine attacks. Collectively, the trials found the percentage of patients that were free of migraine pain at 2 hours postdose ranged from 28.2% to 38.8% compared with placebo of 15.3% to 21.3% (p < 0.001-0.003).Ubrogepant (Ubrelvy) is the first drug in the class of oral calcitonin gene-related peptide (CGRP) antagonists approved for the acute treatment of migraine. Medscape [serial online]. Patients with frequent attacks usually require both. Occipital nerve stimulators may be helpful in patients whose headaches are refractory to other forms of treatment.In December 2013, the FDA approved the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older.
Available at Yarnitsky D, Dodick DW, Grosberg BM, Burstein R, Ironi A, Harris D, et al. Three monoclonal antibodies that bind to the CGRP receptor were approved in the United States in 2018 (ie, erenumab, fremanezumab, galcanezumab). © Copyright 2019, The Headache Pros, Inc. All rights reserved. Available at Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. Neurology. Goadsby PJ, Reuter U, Hallström Y, Broessner G, Bonner JH, Zhang F, et al. ABORTIVE THERAPY PLUS PARENTERAL DEXAMETHASONE — When added to standard acute migraine therapy, parenteral treatment with dexamethasone reduces the rate of early headache recurrence.
Effects of tonabersat on migraine with aura: a randomised, double-blind, placebo-controlled crossover study. While different formulations of a specific triptan may be used in the same 24-hour period, only 1 triptan may be used during this time frame.The longer-acting triptans (eg, frovatriptan, naratriptan) may be used continuously for several days (mini-prophylaxis) to treat menstrual migraine. Treximet contains sumatriptan and naproxen sodium. Friedman BW, Mulvey L, Esses D, et al. Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Lasmiditan is the first of a new drug class, serotonin 5-HT1F receptor agonists (ie, ditans). von Peter S, Ting W, Scrivani S, Korkin E, Okvat H, Gross M, et al. Metoclopramide for acute migraine: a dose-finding randomized clinical trial. Sun-Edelstein C, Mauskop A. Silberstein SD, Dodick DW, Bigal ME, Yeung PP, Goadsby PJ, Blankenbiller T, et al. A study by Friedman et al determined that 20 or 40 mg of metoclopramide is no better in the treatment of acute migraine than 10 mg of the drug.A systematic review by Taggart et al found that ketorolac is an effective alternative agent for the relief of acute migraine headache in the ED. Furthermore, the scientific basis for using most of these medications is wanting.Table 3. For any of these initial prophylactic agents, prophylaxis should not be considered a failure until it has been given at the maximum tolerable dose for at least 30 days.Antiepileptics are generally well tolerated. Schulte-Mattler WJ, Martinez-Castrillo JC. Available at Holroyd KA, Cottrell CK, O'Donnell FJ, Cordingley GE, Drew JB, Carlson BW, et al. Available at Loder E, Weizenbaum E, Frishberg B, Silberstein S; the American Headache Society Choosing Wisely Task Force. Approval was based on a study of 67 migraine patients in which the device reduced the number of migraine days per month and medication use, and on a patient satisfaction study of 2313 device users, in which more than 53% of patients were satisfied with the device.Walling et al looked into developing a non-invasive treatment for medically refractory chronic migraine.