Medicines for the prevention of headaches – choice, effectiveness

In general, prevention of headaches is considered effective in reducing the frequency of attacks by 50% or more. The FDA approved few drugs used to prevent migraine.

The use of most of them was based on the results of clinical trials that confirmed the effectiveness of the treatment of various diseases (mood disorders, coronary heart disease and epilepsy). All non-approved drugs listed in the table showed their effectiveness in open or controlled clinical trials.

Based on the available data on the efficacy of various first, second or third line EFNO drugs, recommendations for their use have been developed. The prophylactic effect of antidepressants is not related to their effect on depression. In any case, patients tolerate drugs better when they are initially used in low doses and slowly titrated to therapeutic doses.

Treatment of chronic headaches with long-acting opioids should not be initiated. The use of long-acting opioids, even with their most appropriate use, will be addictive. During the long-term clinical trial of opioids, in which patients with chronic headaches participated, the use of long-acting opioids had to be stopped in 3/4 of them.

local_offerevent_note January 30, 2019

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