偏头痛预防。

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Ha H,冈萨雷斯

偏头痛预防。

我家人医生。2019年1月1;99 (1):17-24。

PubMed ID

30600979 (在PubMed

]

文摘

偏头痛施加显著的健康和经济负担。大约38%的情景性偏头痛患者将受益于预防治疗,但不到13%采取预防性药物。预防性药物治疗减少偏头痛发作频率、严重程度和headache-related痛苦。预防治疗也可以提高生活质量,防止发展为慢性偏头痛。一些预防性治疗适应症包括四个或更多头痛一个月,八个或更多天头痛一个月,衰弱头痛,和药物过度引起的头痛。识别和管理环境、饮食、和行为预防偏头痛的触发器是有用的策略。一线药物有效建立基于临床证据包括双丙戊酸、托吡酯、美托洛尔、心得安、timolol。药物如阿米替林、文拉法辛、阿替洛尔和nadolol可能有效,但应该是二线治疗。有限的证据nebivolol,比索洛尔,心得乐,卡马西平,加巴喷丁,氟西汀,nicardipine,维拉帕米,nimodipine,硝苯地平,赖诺普利和坎地沙坦。醋丁洛尔,奥卡西平、拉莫三嗪和替米沙坦是无效的。 Newer agents target calcitonin gene-related peptide pain transmission in the migraine pain pathway and have recently received approval from the U.S. Food and Drug Administration; however, more studies of long-term effectiveness and adverse effects are needed. The complementary treatments petasites, feverfew, magnesium, and riboflavin are probably effective. Nonpharmacologic therapies such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic feedback, and cognitive behavior therapy also have good evidence to support their use in migraine prevention.

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药物

Atogepant