Savremeni pristup u lečenju migrena

Abstract

Migraine headache is debillitating disorder that affects millions of people all over the world. The diagnosis of migraine can significantly affects quality of life, health care costs and daily productivity. Hundreds of trials and many guidelines have documented various approaches to migraine management, whether via acute treatment or chronic migraine prophylaxis. Acute or abortive migraine management encompasses specific and nonspecific migraine therapeutics, including nonopioid and opioid analgetics, triptans and ergotamines. Prophylactic migraine management data open the pharmacological spectrum from antiepileptics and antihypertensive agents to botullinum toxine type A. Special coniderations for migraine management also must be applied in varios populations including childern, pregnant women and the elderly. Acute migraines should be menaged with safe, effective and inexpensive medications for acute attacks and severity. Drug choice should be individualized and based on frequency and severity of attacks. The use of abortive therapy depends on its efficasy and tolerabillity and should be considered along with antiemetics in patients suffering from migrains associated with severe nausea and vomiting. Efficacy, functional status, associated symptoms, headache recurrence rate, and use of rescue medications are important considerations when selecting appropriate therapy to menage acute migraine attaks. Use of migraine specific agens continues to be reserved for patients who fall initial treatment with non specific agens. Patients requiring prophyalctis treatment have a wide variety of current options. Comorbid conditions may be considered in helping to determine which profilactic agent will potentially produce the greatest overall treatment effect. Future consideration in migraine profilaxis include further evaluation of the effects of combination prophylactic therapy as well as herbal therapeutics. The approval of aditional agents for maneging migrains instills hope for many migrains sufferers whose symptoms remain uncontrolled. Overall, the ultimate goal of migraine to provide individualized and effective care.