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Neuro clinics 35 migraine 2
 

Neuro clinics 35 migraine 2

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for comments post at www.drpratyush.hpage.com

for comments post at www.drpratyush.hpage.com

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    Neuro clinics 35 migraine 2 Neuro clinics 35 migraine 2 Presentation Transcript

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    • Dr Pratyush Chaudhuri
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    • Drug Dose Route Aspirin 500-650 mg Oral Paracetamol 500 mg-4 g Oral Ibuprofen 200- 300 mg Oral Diclofenac 50-100 mg Oral/IM Naproxen 500-750 mg Oral
    • Drug Dose Route Ergot alkaloids Ergotamine 1-2 mg/d; max-6 g/d Oral Dihydroergotamine 0.75-1 mg SC 5-HT receptor agonists Sumatriptan 25-300 mg 6 mg Orally SC Rizatriptan Naratriptan 10 mg 1mg, 2.5mg Orally orally
    • Drug Dose (mg)/d Route Domperidone 10-80 mg Oral Metoclopramide 5-10 mg Oral/IV Promethazine 50-125 mg Oral/IM Chlorpromazine 10-25 mg Oral/IV
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    • Drugs Dose (mg/d)
      • Betablockers
        • Propranolol (ciplar, betacap)
      40-320
      • Calcium Channel Blockers
        • Flunarizine (sibelium)
        • Verapamil (Calaptin)
      10-20 120-480
      • TCAs
        • Amitriptyline (Libotryp)
      10-20
      • SSRIs
        • Fluoxetine
      20-60
    • Drugs Dose (mg/d)
      • Anti-convulsant
        • Sodium valproate
      600-1200
      • Anti-histaminic
        • Cyproheptadine
      4-8
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    • Cephalalgia 1990; 10: 101-105 *p < 0.001 Variable Placebo (run in) Propranolol-LA 160 Propranolol-LA 80 Frequency (per month) 6.1 3.4* 3.9* Side effects n = 27 n = 18
    • Headache 1998; 28: 607-611 Parameter Baseline End-period Severity score 11.1 6.7*
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    • 48 50 0 10 20 30 40 50 60 70 Flunarizine (p<0.01) Propranolol (p<0.0005) No. of attacks reduced by more than 50% % of Patients Headache 1989; 29: 218-223
    • 1.6 1.6 1.4 1.2* 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 Flunarizine Propranolol Severity score Baseline 16 weeks * p<0.05 Headache 1989; 29: 218-223
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    • That’s all folks!