Abstract

Migraine is one of the most frequent causes for seeking medical attention in primary care, in ambulatory neurological practice, and in ambulance and emergency medicina units. Acute treatment of migraine begins already at the ambulatory practice but extends to emergency medicine. Treatment must be individualized and based on available international treatment guidelines. In the case of mild to moderate intensity of a migraine attack, soluble oral nonsteroidal anti-inflammatory drugs or paracetamol are the preferred choice of treatment. When a migraine attack does not respond to the above mentioned drugs or has severe intensity from the beginning, triptans are indicated. Simultaneous use of metoclopramide or caffeine may enhance the efficacy of treatment. In emergency settings, parenteral administration should be preferred and glucocorticosteroids may be used if necessary. In spite of the multiple treatment options for acute migraine attacks used worldwide, the availability of effective drugs/drug formularies is not satisfactory in Estonia.