Which class of medication is an evidence-based abortive therapy for acute migraine?

Which class of medication is an evidence-based abortive therapy for acute migraine?

• A. Beta-blockers
• B. SSRIs
• C. Antipsychotics
• D. Triptans

Answer: (D)

Triptans are the evidence-based option for stopping a migraine attack once it starts. They work by activating 5-HT1B/1D receptors on cranial blood vessels and on the trigeminal nerve pathways. This dual action causes constriction of intracranial vessels and dampens the release of pain-causing neuropeptides like CGRP, which together reduce the intensity of the headache and relief of associated symptoms such as nausea and photophobia when taken at the onset of an attack. In clinical practice, they are favored for moderate to severe migraines or when quick relief is needed, and they can be used alone or with NSAIDs to improve outcomes. Be mindful of contraindications: they should be avoided in patients with significant cardiovascular disease, uncontrolled hypertension, or a history of stroke/TIA, and separate from ergot-containing medications due to vasoconstriction risks. Other options listed aren’t considered the standard evidence-based abortive therapy for acute migraine. Beta-blockers are used mainly for prevention, SSRIs are not effective for acute relief, and antipsychotics aren’t the primary abortive class, though some can help with associated symptoms.

Triptans are the evidence-based option for stopping a migraine attack once it starts. They work by activating 5-HT1B/1D receptors on cranial blood vessels and on the trigeminal nerve pathways. This dual action causes constriction of intracranial vessels and dampens the release of pain-causing neuropeptides like CGRP, which together reduce the intensity of the headache and relief of associated symptoms such as nausea and photophobia when taken at the onset of an attack.

In clinical practice, they are favored for moderate to severe migraines or when quick relief is needed, and they can be used alone or with NSAIDs to improve outcomes. Be mindful of contraindications: they should be avoided in patients with significant cardiovascular disease, uncontrolled hypertension, or a history of stroke/TIA, and separate from ergot-containing medications due to vasoconstriction risks.

Other options listed aren’t considered the standard evidence-based abortive therapy for acute migraine. Beta-blockers are used mainly for prevention, SSRIs are not effective for acute relief, and antipsychotics aren’t the primary abortive class, though some can help with associated symptoms.