Center for Headache and Pain, Cleveland Clinic, Cleveland, OH 44195, USA.
CNS Drugs. 2012 Oct 1;26(10):823-39. doi: 10.2165/11635440-000000000-00000.
Migraine is a prevalent and disabling brain disorder that costs billions of dollars annually in direct healthcare costs, and school and work absenteeism and presenteeism. The objective of acute treatment is a cost-effective, rapid restoration of functional ability, with minimal recurrence and adverse effects. The acute treatment of migraine includes specific drugs, which currently all have vasoconstrictive effects (dihydroergotamine and triptans), and nonspecific drugs that include paracetamol (acetaminophen), combination analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), dopamine antagonists, narcotics and corticosteroids. NSAIDs have both peripheral and central effects on reversing migraine, and so may represent the best alternative for patients who cannot use triptans and ergots due to vascular contraindications. Narcotics and habituating medications should be avoided in the acute treatment of migraine, as the risk for transformation to chronic daily headache is excessively high at a relatively infrequent rate of exposure.
偏头痛是一种常见且使人丧失能力的脑部疾病，每年在直接医疗保健费用、旷工和出勤但效率低下方面耗费数十亿美元。急性治疗的目标是以具有成本效益的方式快速恢复功能能力，尽量减少复发和不良反应。偏头痛的急性治疗包括特定药物，目前所有这些药物都具有血管收缩作用（二氢麦角胺和曲坦类药物），以及非特异性药物，包括对乙酰氨基酚（扑热息痛）、复方镇痛药、非甾体抗炎药（NSAIDs）、多巴胺拮抗剂、麻醉剂和皮质类固醇。NSAIDs 对偏头痛的逆转具有外周和中枢作用，因此对于因血管禁忌而不能使用曲坦类药物和麦角类药物的患者来说，可能是最佳选择。在偏头痛的急性治疗中应避免使用麻醉剂和易成瘾药物，因为在相对较低的暴露频率下，转化为慢性每日头痛的风险过高。
