ABSTRACT
This chapter aims to look at the Federal Drug Administration-approved medications for the abortive and prophylactic treatment of migraine and cluster headache. Verapamil, a phenylalkylamine, has been evaluated for prophylactic treatment of migraine. The only member of the class of tricyclic antidepressant medications that has proven efficacy in migraine prophylaxis is amitriptyline. In several articles, it was noted that the drugs of first choice for migraine prophylaxis include valproic acid and topiramate, amitriptyline, p-blockers, and flunarizine. The topiramate 100 mg/day and propranolol groups were similar with respect to reductions in the migraine frequency, responder rate, migraine days, and daily rescue medication usage. The most appropriate route of administration of a triptan during a migraine attack, secondary to gastrointestinal dysmotility may be a triptan injection, or in the EU, a suppository may be preferred.
