Neurol. praxi. 2009;10(6):369-371

Prophylactic treatment of migraine

MUDr.Ingrid Niedermayerová

Neurologická ambulance Quattromedica Brno a II. neurologická klinika LF MU a FN Brno

Prophylactic drug treatment is foregrounded in attempt to reduce frequency, duration or severity of migraine attacks, further after inefficiency

or contraindications of acute therapy. Drugs of the first choice are initially administrated, i. e. valproate, topiramate, metoprolol,

flunarizine. If these drugs are not effective, are contraindicated or in case of comorbidity, we use drugs of the second choice (amitriptylin)

or another prophylactic drugs. Monotherapy is preferred at first, prophylactic drugs may be combined. Duration of prophylaxis is usually

6–9–12 months. During menstrual migraine, nonsteroidal anti-inflammatory drugs (naproxen) or triptans (frovatriptan, naratriptan) are

administrated intermittently, another option is hormonal prophylaxis. Using of magnesium is without risk during pregnancy. In resistant

cases metoprolol can be applied. The failure of prophylaxis can be caused by the wrong diagnosis of the headache.

Keywords: migraine, prophylaxis, topiramate, valproate, betablockers, amitriptylin

Published: January 1, 2010  Show citation