- Treat with NSAIDS, APAP, 5-HT receptor antagonists (triptans).
- Prophylaxis: Avoid precipitants, TCAs, propranolol, topiramate, verapamil, valproic acid, NSAIDs, Botox, Magnesium, Vitamin B12, CoQ10, feverfew
- If they are recurrent, interfere with daily activities or patient prefers prophylactic therapy, prophylaxis should be considered. Use lowest effective dose, give 2 – 3-month trial, consider a choice that also helps with comorbidity
- Possibilities: Frovatriptan for menstrual migraines, metoprolol (not in asthma, but may help in HTN), Botox, petasites/butterbur, propranolol, timolol, topiramate, valproic acid
- Triptans are good for an acute migraine.
- Butorphanol has an intranasal route, good for nausea and vomiting
Treatment: APAP, NSAID, ASA, treat depression and anxiety
Prophylaxis: Tricylic antidepressants, Botox
Treatment: triptans, oxygen, intranasal lidocaine, octreotide and 10% cocaine
Prophylaxis: verapamil, melatonin, suboccipital injection of betametasone, lithium (~0. 3 mmol/L, subtherapeutic, dose for bipolar = 0.8 – 12)