Preventive Migraine Treatment.
Preventive Migraine Treatment.
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DOI：
10.1212/con.0000000000000199
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发表时间：
2015-08-01
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影响因子：
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通讯作者：
Silberstein, Stephen D
中科院分区：
文献类型：
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作者：
Silberstein, Stephen D
审查目的：本文回顾了偏头痛的预防性治疗的证据基础。最新发现：偏头痛的预防性治疗的循证指南最近已由美国神经病学学会（AAN）和加拿大头痛学会（CHS）出版，为临床医生提供了有价值的指导。根据AAN，有强有力的证据支持使用美托洛尔、噻吗洛尔、普萘洛尔、双丙戊酸钠、丙戊酸钠和托吡酯预防偏头痛。根据现有的最佳证据，不良事件的概况，和专家的共识，托吡酯，普萘洛尔，纳多洛尔，美托洛尔，阿米替林，加巴喷丁，坎地沙坦，蜂斗菜（款冬），核黄素，辅酶Q10，柠檬酸镁收到了强烈的建议使用CHS.SUMMARY：偏头痛预防药物治疗在临床实践中未充分利用。预防性治疗的原则对于提高依从性、最大限度地减少副作用和改善患者结局非常重要。偏头痛的预防性治疗的选择应基于共病和共存疾病的存在、患者的偏好、生育潜力和计划以及最佳可用证据。
PURPOSE OF REVIEW: This article reviews the evidence base for the preventive treatment of migraine.RECENT FINDINGS: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS.SUMMARY: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence.