Specific and non-specific drugs in the treatment of migraine attacks: new options

The effectiveness of various symptomatic drugs has been documented by controlled clinical trials. A review of the data from the literature has identified a group of substances that proved significantly better than placebo in at least two controlled trials. These drugs include triptans, ergots, non-steroidal anti-inflammatory drugs and anti-emetics. With the exception of ergotamine, which is ineffective or may even worsen nausea, all of them possess both analgesic and anti-emetic effects, provided that they are used according to the proper dosage and administration route. The choice of the appropriate drug, formulation and route of administration is a crucial step in the therapeutic approach of migraine. This choice must be guided by the clinical characteristics of the migraine attack, co-morbid or associated conditions, drug-related factors and patient' preferences.