Öztürk Vesile
Dokuz Eylül University, Medical Faculty, Department of Neurology, İzmir, Turkey.
Noro Psikiyatr Ars. 2013 Aug;50(Suppl 1):S26-S29. doi: 10.4274/Npa.y7299. Epub 2013 Aug 1.
Migraine is one of the most frequent disabling neurological conditions with a major impact on the patient's quality of life. Migraine has been described as a chronic disorder that characterized with attacks. Attacks are characterized by moderate-severe, often unilateral, pulsating headache attacks, typically lasting 4 to 72 hours. Migraine remains underdiagnosed and undertreated despite advances in the understanding of its pathophysiology. This article reviews management of migraine acute pharmacological treatment. Currently, for the acute treatment of migraine attacks, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans (serotonin 5HT1B/1D receptor agonists) are recommended. Before intake of NSAID and triptans, metoclopramide or domperidone is useful. In very severe attacks, subcutaneous sumatriptan is first choice. The patient should be treated early in the attack, use an adequate dose and formulation of a medication. Ideally, acute therapy should be restricted to no more than 2 to 3 days per week to avoid medication overuse.
偏头痛是最常见的致残性神经系统疾病之一，对患者的生活质量有重大影响。偏头痛被描述为一种以发作为特征的慢性疾病。发作的特点是中度至重度、通常为单侧的搏动性头痛发作，通常持续4至72小时。尽管对偏头痛的病理生理学有了进一步了解，但偏头痛的诊断和治疗仍不足。本文综述了偏头痛急性药物治疗的管理。目前，对于偏头痛发作的急性治疗，推荐使用非甾体抗炎药（NSAIDs）和曲坦类药物（5-羟色胺1B/1D受体激动剂）。在服用NSAIDs和曲坦类药物之前，甲氧氯普胺或多潘立酮是有用的。在非常严重的发作中，皮下注射舒马曲坦是首选。患者应在发作早期接受治疗，使用足够剂量和剂型的药物。理想情况下，急性治疗应限制在每周不超过2至3天，以避免药物过度使用。
