What is drug of choice for acute attack of migraine- (AIIMS May 2014)
Acute Attack Therapies for Migraine
1. NSAIDs are the drug of choice for early migraine
2. 5-HT1 Agonists:
a. Stimulation of 5-HT 1B/1D receptors can stop an acute migraine attack.
b. Ergotamine and dihydroergotamine are nonselective receptor agonists.
c. The triptans are selective 5-HT 1B/1D receptor agonists.
d. Sumatriptan affect Blood flow by decreasing cerebral vasodilatation. Example of triptans (e.g naratriptan, rizatriptan, eletriptan, sumatriptan, zolmitriptan, almotriptan, frovatriptan).
Extra Edge: Drug of choice of early stage acute attack of migraine = NSAID (Ref. Hari-18th ed., Pg 114)
3. Dopamine antagonists
Chlorpromazine, prochlorperazine, metoclopramide.
Preventive treatments in migraine (Ref. Hari-18th ed., Pg-121)
2. Beta blocker: Propranolol
3. Tricyclic: amitriptyline Dothiepin, Nortriptyline
4. Anticonvulsants : Topiramate, Valproate, Gabapentin
5. Serotonergic drugs: Methysergide, Flunarizine
Drugs which are not effective as migraine prophylaxis: Verapamil, Nimodipine, Clonidine, SSRIS, fluoxetine