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Yıl:2013; Cilt: 50; Sayı: Ek 1>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2013;50(Ek 1):26-29
Migren Akut Tedavisi
V Öztürk
Dokuz Eylül Üniversitesi, İzmir
Migren, hastaların yaşam kalitesi üzerinde önemli bir etkiye sahip sık rastlanan nörolojik durumlardan biridir. Ataklarla karakterize kronik bir hastalık olarak tanımlanır. Ataklar genellikle 4 ile 72 saat süren, orta ya da şiddetli, genellikle tek taraflı, zonklayıcı baş ağrısı ile karakterizedir. Migren patofizyolojisinin daha iyi anlaşılmasına rağmen, tanınması ve tedavisi hala yeterli değildir. Bu makalede migrende akut farmakolojik tedavi yaklaşımı gözden geçirilmiştir. Günümüzde, migren ataklarının akut tedavisi için, non-steroid antiinflamatuar ilaç (NSAİİ) ve triptanlar (serotonin 5HT1B/1D reseptör agonistleri) önerilir. NSAİİ ve triptan alımından önce, metoklopramid veya domperidonun verilmesi faydalıdır. Çok şiddetli ataklarda subkutan sumatriptan ilk seçenektir. Hasta, yeterli dozda ve formülasyonda bir ilaç ile atağın erken döneminde tedavi edilmelidir. İdeal olarak, ilaç aşırı kullanımını önlemek için akut tedavi haftada en fazla 2 -3 gün ile sınırlandırılmalıdır.
Acute Treatment of Migraine
Migraine is one of the most frequent disabling neurological conditions with a major impact on the patient’s quality of life. Migraine has been described as a chronic disorder that characterized with attacks. Attacks are characterized by moderate– severe, often unilateral, pulsating headache attacks, typically lasting 4 to 72 hours. Migraine remains underdiagnosed and undertreated despite advances in the understanding of its pathophysiology. This article reviews management of migraine acute pharmacological treatment. Currently, for the acute treatment of migraine attacks, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans (serotonin 5HT1B/1D receptor agonists) are recommended. Before intake of NSAID and triptans, metoclopramide or domperidone is useful. In very severe attacks, subcutaneous sumatriptan is first choice. The patient should be treated early in the attack, use an adequate dose and formulation of a medication. Ideally, acute therapy should be restricted to no more than 2 to 3 days per week to avoid medication overuse.

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