Treatment and management of migraine

The chapter is a review of the possible treatment options for acute migraine. This primary headache disorder has a huge social and economic impact. The combination of a correct diagnosis, good general management and the election of the most appropriate pharmacological treatment can significantly reduce the patient’s disability. Here we provide a thorough description of the most commonly used specific (ergots and triptans) and nonspecific (analgesics, NSAIDs, dopamine antagonists, etc.) medications, as well as some of their effective combinations. We discuss how to use the different medications in relation with the clinical presentation of the migraine attacks and in special situations as status migrainosus, or refractoriness to conventional treatment. Advantages and disadvantages of the most used strategies are pointed out to assist professionals to choose the best individual treatment for their patients with acute migraine attack.