Acute treatment of migraine

Neurol Clin. 2009 May;27(2):417-27. doi: 10.1016/j.ncl.2008.11.008.


The goals of acute treatment of migraine are cost-effective rapid relief, consistent reduction of disability, and reduced use of rescue medications. Key to acute treatment is matching medication to disability as a surrogate marker for disease severity with a stratified care approach. In the absence of vascular contraindications, triptans are first-line acute treatments for disabling migraine. Acute treatment success can be assessed with use of the paper tool, Migraine-ACT. Opioids and butalbital should be avoided in acute migraine treatment. Triptan type can be selected for patients by differences in speed or effect, formulation, and formulary tier.

Publication types

  • Review

MeSH terms

  • Emergency Treatment*
  • Ergotamine / administration & dosage
  • Ergotamine / adverse effects
  • Ergotamine / therapeutic use*
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / physiopathology
  • Time Factors
  • Treatment Outcome
  • Tryptamines / administration & dosage
  • Tryptamines / adverse effects
  • Tryptamines / therapeutic use*
  • Vasoconstrictor Agents / administration & dosage
  • Vasoconstrictor Agents / adverse effects
  • Vasoconstrictor Agents / therapeutic use*


  • Tryptamines
  • Vasoconstrictor Agents
  • Ergotamine