Migraines are characterised by headaches lasting several hours, which recur regularly. Even if in some cases the intensity or frequency of the migraines causes considerable difficulties, they do not expose the sufferer to life-threatening complications.
Preventive treatment should be considered on a case-by-case basis, depending on the frequency and intensity of the migraines, and the consumption of drugs when they occur.
The leading preventive drug is propranolol because of its proven effectiveness and acceptable adverse effects. The main alternatives are valproic acid and amitriptyline. Topiramate does not seem to be as effective as propranonol, while its adverse effects are more frequent and sometimes serious.
Because of the fluctuation in the frequency of migraines in a patient, it is advisable to consider stopping the preventative treatment regularly.
©Prescrire May 2006
Source: "Prévention médicamenteuse des crises de migraine : à décider au cas par cas" Rev Prescrire 2006 ; 26 (271) : 276-281.
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