![]() ![]() They could also be a game-changer for those who experienced the long list of side effects (or didn't find relief) on other drugs such as triptans, antidepressants, and seizure or blood pressure medications, especially people with refractory migraines who feel they have "run out of options," Dr. These innovations open the door for migraine patients with heart disease, stroke and vascular diseases, who couldn't safely take the older class of triptan migraine medications. "For people finding they need to take a lot of breakthrough medications, gepants would be a good option because they're less likely to develop rebound headaches," she says. Medication overuse underlies many cases of episodic migraines that become chronic. Providers suggest taking acute headache treatments no more than 10 days each month, because overindulging in either over-the-counter drugs or triptans can cause headaches. The ability to take Nurtec both for prevention and acute treatment implies that it does not have the same overuse limitations as existing drugs, Dr. Lasmiditan (Reyvow) is a separate type of treatment that targets the serotonin receptors on brain nerve endings to halt migraine attacks as they occur. The Food and Drug Administration approved the most recent, atogepant (Qulipta), in September 2021. Ubrelvy is used to help treat acute migraines, while Qulipta is used for migraine prevention. These medications, include Ubrelvy (ubrogepant), Nurtec (rimegepant) and Atogepant (Qulipta). Epub 2020 Sep 14.Another newer group of drugs targets the same molecule but is provided orally. MAGraine: Magnesium compared to conventional therapy for treatment of migraines. Nevertheless, it appears that IV magnesium has similar efficacy compared to metoclopramide and prochlorperazine and may be used as a safe alternative or adjunct for migraine treatment. There were several limitations in this study, including the unexpected premature termination of recruitment leading to the study being underpowered and potential confounding due to multiple additional adjunctive treatments given before and after the study medications. Though not statistically significant, there were more adverse effects with prochlorperazine (specifically dizziness, akathisia, and anxiety), and more patients in the magnesium group needed rescue analgesia. There were no statistically significant differences in ED length of stay, rescue analgesia, or adverse effects, and a post hoc analysis determined that magnesium was non-inferior to the other treatment modalities. Figure 2 from the study below depicts the effect of the treatment medications on the median pain scores. Overall, there was no significant difference in change in pain score (NRS) at 30 minutes, 60 minutes, and 120 minutes between the treatment groups. This was a single-center, prospective, double-blinded, randomized-controlled trial comparing IV magnesium 2 g, metoclopramide 10 mg, and prochlorperazine 10 mg for the treatment of migraine. ![]() What’s in your migraine cocktail? I prefer my magnesium shaken, not stirred. ![]() IV magnesium is a relatively safe and inexpensive treatment option for migraines, but how effective is it compared to some of the other first line medications such as metoclopramide and prochlorperazine? Pain control is the cornerstone of management, and everyone seems to have their own go-to migraine cocktail. Migraine headaches are a common reason for acute care presentation. Therefore, IV magnesium may be a useful alternative or adjunct in your standard migraine cocktail. Intravenous (IV) magnesium appeared to have similar efficacy for migraine treatment compared to metoclopramide and prochlorperazine. ![]()
0 Comments
Leave a Reply. |