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Therapieempfehlungen der European Federation Neurological Societies (EFNS) [Pharma]
30 Apr 06
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Ergebnisse einer EFNS-Task-Force |
Eine Task Force der European Federation Neurological Societies (EFNS) hat gemeinsame Migräne-Richtlinien erarbeitet. Die Ergebnisse:
Akutbehandlung: NSAIDs und Triptane. Vor der Einnahme der Mittel werden MCP oder Domperidon empfohlen. Bei sehr schweren Attacken: Acetylsalicylsäure (ASS) intravenös (Aspisol) oder Sumatriptan subkutan. Bei Status migraenosus: Kortison.
Prophylaxe: Propranolol, Metroprolol, Flunarizin, Valproinsäure, Topiramat sind die Wirkstoffe der ersten Wahl. An 2. Stelle folgen: Amitriptylin, Naproxen, Pestwurz, Bisoprolol.
Abstract:
EFNS guideline on the drug treatment of migraine – report of an EFNS task force.
Migraine is one of the most frequent disabling neurological conditions with a major impact on the patients' quality of life. To give evidence-based or expert recommendations for the different drug treatment procedures of the different migraine syndromes based on a literature search and an consensus in an expert panel. All available medical reference systems were screened for all kinds of clinical studies on migraine with and without aura and on migraine-like syndromes. The findings in these studies were evaluated according to the recommendations of the EFNS resulting in level A,B, or C recommendations and good practice points. For the acute treatment of migraine attacks, oral non-steroidal anti-inflammatory drugs (NSAIDs) and triptans are recommended. The administration should follow the concept of stratified treatment. Before intake of NSAIDs and triptans, oral metoclopramide or domperidon is recommended. In very severe attacks, intravenous acetylsalicylic acid or subcutaneous sumatriptan are drugs of first choice. A status migrainosus can probably be treated by steroids. For the prophylaxis of migraine, betablockers (propranolol and metoprolol), flunarizine, valproic acid, and topiramate are drugs of first choice. Drugs of second choice for migraine prophylaxis are amitriptyline, naproxen, petasites, and bisoprolol.
Evers, S., Áfra, J., Frese, A., Goadsby, P. J., Linde, M., May, A. & Sándor, P. S. (2006) EFNS guideline on the drug treatment of migraine – report of an EFNS task force. European Journal of Neurology 0 (0), -. doi: 10.1111/j.1468-1331.2006.01411.x
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