ISSN:0014-3022    

DOI:10.1159/000119523

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The introduction of the International Headache Society (IHS) diagnostic criteria has made migraine a ‘positive’ diagnosis, not one of exclusion. Studies in Canada have shown that many sufferers do not consult their physician about their migraine, and that the use of over-the-counter and prescription analgesics is common. Treatment should comprise a physician-patient partnership based on a correct and accepted diagnosis, in which both participate in a programme of education about the condition, identification and reduction of migraine triggers, and appropriate use of non-pharmacological, prophylactic and acute pharmacological treatments. The pathogenesis of chronic daily headache is uncertain, but it is frequently associated with habitual overuse of simple analgesics and ergotami

ISSN:0014-3022    

DOI:10.1159/000119524

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To obtain accurate estimates of migraine prevalence, population-based studies are required. Clinic-based studies include a highly selected group of migraine sufferers. Even in population-based studies, there have been wide variations in estimates of migraine prevalence. A meta-analysis has shown that age, gender and case definition account for 70% of this variance. Recent studies using International Headache Society (IHS) diagnostic criteria have given relatively consistent estimates of migraine prevalence (about 15–18% of women and 6% of men) and indicate that migraine occurs most commonly in men and women aged 25-55 years. Migraine is a heterogeneous condition with a spectrum of severity and associated disability, and it is under-diagnosed worldwid

ISSN:0014-3022    

DOI:10.1159/000119525

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Migraine is an episodic disorder which is often disabling both during and between attacks. While pain intensity is the most important symptom to individual sufferers, headache-related disability is the major determinant of the economic impact of illness. Because migraine is underdiagnosed and under-treated, cost-effective healthcare interventions could serve to reduce the burden of illness on individual sufferers and society. Measures which assess both pain intensity and disability might serve to capture the essential elements of migraine and provide the basis for effective healthcare interventions.

ISSN:0014-3022    

DOI:10.1159/000119527

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Acute drug therapy is the mainstay of treatment for migraine sufferers, with prophylaxis reserved for those with frequent or severe attacks. The majority of treatments have been in use for many years, although their value is often poorly documented due to a lack of well-controlled trials undertaken with defined diagnostic criteria and study end-points. Analgesics with anti-emetics, nonsteroidal anti-inflammatory drugs and ergot derivatives are used for acute treatment. Recently, the selective 5-HT1 receptor agonist sumatriptan has become available and been shown to have significant benefits over traditional therapies for the acute treatment of migraine. Beta-blockers, flunarizine and 5-HT2 antagonists have been used for prophylaxis, and although many patients report a reduction in attack frequency, breakthrough attacks still occur.

ISSN:0014-3022    

DOI:10.1159/000119528

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The efficacy of the 5-HT1 receptor agonist sumatriptan in the acute treatment of migraine has been investigated in an extensive programme of controlled clinical trials. Sumatriptan provided rapid relief from migraine headache with onset of relief occurring within 10 min of a 6 mg subcutaneous injection and within 30 min of a 100 mg oral dose. Maximum benefit was observed by 2 h after the injection and 4 h after the oral dose. Sumatriptan also significantly decreased the incidence of associated migraine symptoms (nausea, photophobia, phonophobia) and the need for rescue medication. Sumatriptan was an effective treatment for migraine with and without aura and when used at any time during the attack. Oral sumatriptan 100 mg provided significantly greater pain relief and had a more rapid onset of action than two commonly used acute treatments for migraine. Efficacy is maintained in long-term use, with no evidence of tachyphylaxis or dependence. Sumatriptan, whether given sub-cutaneously or orally, is an effective long-term acute treatment for migraine.

ISSN:0014-3022    

DOI:10.1159/000119529

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Cluster headache is a rare form of severe idiopathic headache characterized by unilateral short-lasting episodes of excruciating pain in association with autonomic disturbances. Subcutaneous sumatriptan has been investigated as an acute treatment for cluster headache in two randomized, double-blind, placebo-controlled, crossover trials. About 75% of patients given subcutaneous sumatriptan 6 mg reported headache relief within 15 min, in comparison with 26-35% given placebo (p < 0.001 in both studies). The need for rescue medication (100% oxygen by inhalation) at 15 min was significantly lower after sumatriptan treatment as were the severity of functional disability and incidence of non-headache symptoms. Results of a long-term study indicate that the tolera-bility and efficacy of sumatriptan 6 mg is maintained in long-term use, and that there is no evidence of tachyphylaxis.

ISSN:0014-3022    

DOI:10.1159/000119530

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The safety and tolerability of sumatriptan have been extensively studied. The majority of adverse events (defined as any medical event irrespective of possible causal relationship to treatment) were mild to moderate in intensity, transient and resolved spontaneously. In short-term studies, the most frequently reported adverse events were nausea, vomiting, dizziness, vertigo, malaise, fatigue, injection-site reactions, heaviness, pressure, feelings of warmth and headache. The adverse event profile was unchanged during long-term open treatment and was unaffected by frequency of treatment with sumatriptan. In 3-5% of patients, the symptoms of pressure and warmth were experienced in the chest, but extensive investigations, including ECG monitoring, have indicated that these symptoms are not normally associated with cardiac dysfunction.

ISSN:0014-3022    

DOI:10.1159/000119531

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000119532

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000117011

出版商:S. Karger AG    

年代:1994

数据来源: Karger