Migraine prophylaxis

There is a wide array of options for migraine prophylaxis; many of the available drugs are clearly proven to be effective and yet are underused in Australia. "New" drugs which are gaining favour for migraine prophylaxis include topiramate, candesartan, gabapentin and botulinum toxin. The e...

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Bibliographic Details
Published inMedical journal of Australia Vol. 189; no. 5; p. 283
Main Authors Stark, Richard J, Stark, Catherine D
Format Journal Article
LanguageEnglish
Published Australia 01.09.2008
Subjects
Australia
Cardiovascular Agents - therapeutic use
Central Nervous System Agents - therapeutic use
Glucocorticoids - therapeutic use
Humans
Migraine Disorders - drug therapy
Migraine Disorders - etiology
Migraine Disorders - prevention & control
Australia
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Summary:There is a wide array of options for migraine prophylaxis; many of the available drugs are clearly proven to be effective and yet are underused in Australia. "New" drugs which are gaining favour for migraine prophylaxis include topiramate, candesartan, gabapentin and botulinum toxin. The evidence for efficacy is excellent for topiramate and reasonably good but limited for candesartan and gabapentin. The use of botulinum toxin is controversial and has gained substantial popularity through anecdotal experience rather than convincing published evidence. Transformed or chronic migraine with medication overuse is a particularly difficult problem. New strategies to aid in medication withdrawal are reviewed. The approach to menstrual migraine and migraine with prominent aura may differ from that for typical migraine. Novel approaches are being explored for these problems.
ISSN:0025-729X
DOI:10.5694/j.1326-5377.2008.tb02028.x