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. #Migraine #Headache #Treatment #Prophylaxis #management
