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Pharmacologic therapies for migraine have traditionally been divided into 2 broad and distinct categories.1–3 Acute treatments are given at the time of a migraine attack to relieve pain and restore function. Preventive treatments are usually taken on a daily basis to reduce the frequency of headaches. Conventional wisdom suggests that the drugs used as acute treatments (i.e., triptans, ergot alkaloids, nonsteroidal anti-inflammatory agents) differ from the drugs used as preventive treatments (antiepilepsy drugs, β-blockers, calcium channel blockers, and antidepressants) in mechanism of action, pharmacokinetic profiles, and patterns of use. Some acute treatments, particularly opioids and barbiturates, if used too often, might lead to worsening of headaches in a process variously conceptualized as transformation, chronification, or the development of medication overuse headache.4
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See page 958
- © 2014 American Academy of Neurology
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