Rescue Therapy for Acute Migraine, Part 1: Triptans, Dihydroergotamine, and Magnesium

  title={Rescue Therapy for Acute Migraine, Part 1: Triptans, Dihydroergotamine, and Magnesium},
  author={Nancy E. Kelley and Deborah E Tepper},
  journal={Headache: The Journal of Head and Face Pain},
Objective.— To review and analyze published reports on the acute treatment of migraine headache with triptans, dihydroergotamine (DHE), and magnesium in emergency department, urgent care, and headache clinic settings. 

Rescue Therapy for Acute Migraine, Part 3: Opioids, NSAIDs, Steroids, and Post‐Discharge Medications

Objective.— The final section of this 3‐part review analyzes published reports involving the acute treatment of migraine with opioids, non‐steroidal anti‐inflammatory drugs (NSAIDs), and steroids in

Rescue Treatment for Migraine Headache in Emergency Department Part 2: Role of Antiepileptic, Magnesium, Corticosteroids, and Discharge Care

Nearly half of patients with migraine headaches discharged from the ED had received neither a specific diagnosis nor appropriate patient education, so discharge planning and a migraine education program at the ED was also highlighted in this article.

Intravenous Therapies for Intractable Headache

This chapter reviews several pharmacological options of intravenous infusions for intractable headaches and recommends several new drugs for treatment of refractory headaches.

Real-world economic impact of onabotulinumtoxina in patients with chronic migraine

OnabotulinumtoxinA can be used effectively for headache prophylaxis in CM patients with CM, but the effect of treatment on HRU is unknown.

Pharmacologic Management of Acute Migraines in the Emergency Department

The best evidence behind some of the medications frequently used to treat acute migraines in the ED setting are reviewed, including dopamine receptor antagonists, serotonin receptor agonists, anti-inflammatory medications, opioids, magnesium, valproate, and propofol.

Acute Treatment of Migraines

NSAIDs have both peripheral and central effects on reversing migraine, and so may represent the best alternative for patients who cannot use triptans and ergots due to vascular contraindications.

Acute Migraine Management in Children

Development of emergency department guidelines for the management of pediatric migraines should be based on up-to-date evidence supporting safe, appropriate therapies for children, and requiring prompt nuanced recognition by emergency personnel and implementation of an effective treatment strategy.

Metoclopramide versus sumatriptan in the treatment of migraine in the emergency department: a single-center, open-label, cluster-randomized controlled non-inferiority trial.

Whether metoclopramide 10 mg intravenously (IV) is non-inferior to sumatriptan 3 mg subcutaneously (SQ) as migraine treatment in the ED is investigated, and if this hypothesis is confirmed, metoclobramide can be considered as first-line medication for migraine attacks in ED settings.

Acute Migraine Management in Children.

Development of emergency department guidelines for the management of pediatric migraines should be based on up-to-date evidence supporting safe, appropriate therapies for children, according to the Agency for Healthcare Research and Quality.

Migraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action

The current approach and concepts relevant to the acute pharmacological treatment of migraine will be explored in this review.



Comparison of Intravenous Valproate Versus Intramuscular Dihydroergotamine and Metoclopramide for Acute Treatment of Migraine Headache

Objective.—To determine the effectiveness and tolerability of intravenous valproate for the acute treatment of migraine headache with or without aura (International Headache Society diagnostic

Efficacy of Intravenous Magnesium Sulfate in the Treatment of Acute Migraine Attacks

Objective.—To study the efficacy and tolerability of 1 g of intravenous magnesium sulfate as acute treatment of moderate or severe migraine attacks.

The Emergency Treatment of Acute Migraine Headache; A Comparison of Intravenous Dihydroergotamine, Dexamethasone, and Placebo.

Introduction The-traditional treatment of migraine headaches in the emergency room setting has been parenteral narcotics. There are several disadvantages to this therapy including: low rate of

A Clinical Trial of Trimethobenzamide/Diphenhydramine Versus Sumatriptan for Acute Migraines

Open‐label studies suggest that the combination of trimethobenzamide and diphenhydramine (TMB/DPH) may provide effective relief in a high proportion of migraineurs.

Comparison of single dose meperidine, butorphanol, and dihydroergotamine in the treatment of vascular headache

Post-treatment pain scores were lowest in the DHE group (p <0.01), and eight of 21 patients receiving DHE had greater than 90% reduction in pain compared with three of 19 patients receiving butorphanol and none of 22 receiving meperidine.

Triptans: Do they differ?

Whether other triptans offer clinically significant advantages over sumatriptan is examined by considering the similarities and differences among triptan.

Comparison of Dihydroergotamine With Metoclopramide Versus Meperidine With Promethazine in the Treatment of Acute Migraine

The dihydroergotamine with metoclopramide regimen is effective, and has minimal side effects, making it an attractive method for office‐based treatment of acute migraine.

Terminating Migraine With Allodynia and Ongoing Central Sensitization Using Parenteral Administration of COX1/COX2 Inhibitors

Whether delayed infusion of COX1/COX2 inhibitors (ketorolac, indomethacin) will stop migraine in allodynic patients, and suppress ongoing sensitization in central trigeminovascular neurons in the rat is studied.

Intravenous Metamizol (Dipyrone) in Acute Migraine Treatment and in Episodic Tension-Type Headache–A Placebo-Controlled Study

Significant improvement of pain after 30 min and 60 min post-dosage was achieved from metamizol groups compared with placebo groups and it may be regarded as a good alternative drug for the treatment of common acute primary headaches.

Less Is Not More: Underutilization of Headache Medications in a University Hospital Emergency Department

Objective.—To gain knowledge of episodic headache patients who seek care at an urban university emergency department (ED), to evaluate the care they receive and to examine the impact of the ED on