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afya
Migraine
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> ''Mx'' 5HT agonists for acute Rx - Zolmitriptan 5HT antagonists for prophylaxis - Topiramate or Propranolol (better for women) ''Acute'' - oral triptan plus NSAID or PCM if teenager - nasal triptan if needed add in non-oral metoclopramide (beware acute dystonia in young) or prochlorperazine +/- non-oral NSAID or triptan ''Prophylaxis'' If 2 or more per month effective in 60% Topiramate or propranolol (better in child bearing age women as topiramate is ?teratogenic) 2nd line acupuncture (10 sessions over 5-8/52) or gabapentin Riboflavin (400mg od) may be helpful predictable menstrual migraine - use frovatriptan (2.5mg bd) or zolmitriptan (2.5mg bd/tds) Pizotifen - avoid (wt gain and drowsy) COCP is CI
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Headache