The study of the clinical evolution and pharmacotherapy of migraine

Abstract

Introduction. Migraine is the most common neurological disorder, affecting about 12-15% of people. In R. Moldova, migraine occurs in about 10% of the population, most commonly among women in the age group from 20 to 35 years. Migraine has an ancient history, being known since Neolithic. However, it is surprising that the effective anti-migraine drugs have, until recently, been limited in number. Only in recent decades, great steps have been taken in the development of anti-migraine drugs. Aim of study. To determine the clinical features of migraine and its treatment methods. Materials and methods. The study of clinical cases with migraine was carried out during the period 2019-2020 in hospitals and in the community pharmacies, with 133 research subjects, 28-55 years old. Results. From the total number of investigated 133 patients, 36 were women (58.1%) with a mean age of 41 years old. 47.3% patients showed the presence of migraine without aura and 22.7% - migraine with aura, 11.5% had rare episodic migraine, 48.3% - frequent episodic migraine, and 29.2% - chronic migraine. The study determined that patients suffered more than 5 attacks in 84% of cases. moderate or severe pain intensity in 73% of patients and associated symptoms, such as nausea and/or vomiting; photophobia and phonophobia in 67% of patients. Analgesics are the medication of choice in the treatment of mild-moderate migraine attacks, with administration of ibuprofen 200-800 mg (37%) and of preparations with the fixed combination of acetylsalicylic acid, paracetamol, peopiphenazone, ergotamine, caffeine etc., such as: Nomigren, Migretil, Antinevralgic, which are more effective in the treatment of acute migraine than each compound separately. The hospital treatment includes reduced number of specific preparations for migraine, but are present drugs from various pharmacological groups, with nootropic, cerebroprotective, anxiolytic and antidepressant actions. This fact can be explained by the presence of comorbidities in association with the migraine attacks, which requires complex neurological treatment and not just the specific antimigrenous one. Conclusions. In light-medium migraine pharmacotherapy, simple analgesics, such as ibuprofen and paracetamol, are recommended, combined with the fixed association antimigraine drugs, anti-emetics and avoidance of triggering factors. In the hospital treatment of migraine are administered preparations from various pharmacological groups with nootropic, cerebroprotective, anxiolytic and antidepressant actions, for the purpose of treatment and comorbidities.