Journal
EXPERT OPINION ON DRUG SAFETY
Volume 14, Issue 5, Pages 667-681Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14740338.2015.1014797
Keywords
efficacy; migraine; prophylactic treatment; safety; tolerability
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Funding
- Hungarian Brain Research Programme (NAP) [KTIA_13_NAP-A-III/9]
- EUROHEADPAIN (FP7-Health-Innovation) [602633]
- MTA-SZTE Neuroscience Research Group of the Hungarian Academy of Sciences
- University of Szeged
- [TAMOP-4.2.2.A-11/1/KONV-2012-0052]
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Introduction: Migraine is a frequent, disabling primary headache disorder, whose pathomechanism is not yet fully understood. Prophylactic treatment is advisable for migraineurs with severe or highly frequent attacks, which impair the quality of life. Areas covered: The different types of prophylactic migraine drugs are discussed, with particular regard to potential adverse effects and safety issues. beta-Adrenergic blockers, antiepileptic drugs and calcium-channel blockers are drugs widely used for migraine prevention, whereas complementary medicine and onabotulinumtoxin A can be used in selected cases. Expert opinion: The background of the recurrence and chronification of migraine attacks has not been fully clarified, and causative preventive therapy is therefore not currently available. The tolerability and adverse effects of the currently used medications often limit their use. beta-Adrenergic receptor blockers may induce adverse cardiovascular events, whereas flunarizine is frequently associated with a weight gain and depression. As most migraine sufferers are young women of child-bearing age, the use of valproate is limited. Topiramate is associated with central nervous system-related side effects. There is a need for future development of pathomechanism-based preventive drugs, and personalized therapy tailored to the patient.
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