Topics in migraine management - A survey of headache specialists highlights some controversies

A survey of headache specialists and the recent Headache Consortium Guidelines provides a springboard for discussing important topics in migraine management. The following issues involving triptans are discussed: selection of an acute medication; efficacy and recurrence rates; potential for coronary artery vasoconstriction; serotonin syndrome; and pregnancy and breastfeeding. Indications, principles of management, and efficacy of preventative medications are also reviewed. Treatment of migraine with prolonged aura and basilar migraine are anecdotally based. This article concludes with a look at the use of oral contraceptives in migraine.