Most important drugs to treat migraine
- Symptomatic treatments : Analgesics that have no action on the underlying cause of the migraine headache. Examples include aspirin, ibuprofen, acetaminophen, codeine, and meperidine. It is usually best to avoid narcotic preparations in the treatment of chronic illnesses if at all possible.
- Abortive therapies : Vasoactive agents that modify the vasculature so that the migraine headache is aborted before becoming fully developed. Serotonin receptor partial agonists (“triptans”) such as sumatriptan are most commonly used, though ergotamine derivatives are also sometimes employed, particularly in the management of prolonged or refractory headaches.
- Prophylactic medications : Drugs that prevent the migraine headaches from occurring. Examples include beta-blockers, calcium channel blockers, antiepileptic medications (sodium valproate and topiramate), tricyclic antidepressants (amitriptyline), and cyproheptadine (an antihistamine that is also a serotonin receptor antagonist).