Pharmacological options for the treatment of chronic migraine pain

Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):383-407. doi: 10.1016/j.bpa.2020.08.002. Epub 2020 Aug 8.

Abstract

Migraine is a debilitating neurological condition with symptoms typically consisting of unilateral and pulsating headache, sensitivity to sensory stimuli, nausea, and vomiting. The World Health Organization (WHO) reports that migraine is the third most prevalent medical disorder and second most disabling neurological condition in the world. There are several options for preventive migraine treatments that include, but are not limited to, anticonvulsants, antidepressants, beta blockers, calcium channel blockers, botulinum toxins, NSAIDs, riboflavin, and magnesium. Patients may also benefit from adjunct nonpharmacological options in the comprehensive prevention of migraines, such as cognitive behavior therapy, relaxation therapies, biofeedback, lifestyle guidance, and education. Preventative therapies are an essential component of the overall approach to the pharmacological treatment of migraine. Comparative studies of newer therapies are needed to help patients receive the best treatment option for chronic migraine pain.

Keywords: chronic pain; migraine; pharmacology; preventive therapy; therapeutics.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Analgesics / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anticonvulsants / administration & dosage
  • Antidepressive Agents / administration & dosage
  • Calcium Channel Blockers / administration & dosage
  • Chronic Pain / diagnosis*
  • Chronic Pain / drug therapy*
  • Chronic Pain / physiopathology
  • Cognitive Behavioral Therapy / methods
  • Histamine Antagonists / administration & dosage
  • Humans
  • Migraine Disorders / diagnosis*
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / physiopathology
  • Relaxation Therapy / methods

Substances

  • Adrenergic beta-Antagonists
  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticonvulsants
  • Antidepressive Agents
  • Calcium Channel Blockers
  • Histamine Antagonists