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Nervenheilkunde 2008; 27(10): 933-949
DOI: 10.1055/s-0038-1627343
Deutsche Gesellschaft für Neurologie
Schattauer GmbH

Akuttherapie und Prophylaxe der Migräne

Leitlinie der Deutschen Migräne- und Kopfschmerzgesellschaft und der Deutschen Gesellschaft für NeurologieAcute therapy and prophylaxis of migraineGuidelines of the German Migraine and Headache Society and of the German Neurological Society
S. Evers
1   Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster
,
A. May
2   Institut für Systemische Neurowissenschaften, Universitätsklinikum Eppendorf, Hamburg
,
G. Fritsche
3   Klinik und Poliklinik für Neurologie, Universitätsklinikum Essen
,
P. Kropp
4   Institut für Medizinische Psychologie, Zentrum für Nervenheilkunde, Universitätsklinikum Rostock
,
C. Lampl
5   Abteilung für Allgemeine Neurologie, Krankenhaus der Barmherzigen Brüder, Linz, Österreich
,
V. Limmroth
6   Neurologische Klinik, Kliniken der Stadt Köln, Krankenhaus Merheim
,
V. Malzacher
7   Neurologische Praxis, Reutlingen
,
P. Sandor
8   Neurologische Klinik und Poliklinik, Universität Zürich, Schweiz
,
A. Straube
9   Neurologische Klinik der Universität München, Klinikum Großhadern
,
H.-C. Diener
3   Klinik und Poliklinik für Neurologie, Universitätsklinikum Essen
› Author Affiliations
Further Information

Publication History

Eingegangen am: 16 August 2008

angenommen am: 20 August 2008

Publication Date:
22 January 2018 (online)

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Zusammenfassung

Die Deutsche Migräne- und Kopfschmerzgesellschaft und die Deutsche Gesellschaft für Neurologie legen eine revidierte Fassung ihrer gemeinsamen evidenzbasierten Leitlinie für die Therapie der Migräne vor. Zur Akuttherapie der leichten Migräneattacke wird die frühzeitige und hochdosierte Einnahme von NSAR oder von Paracetamol empfohlen. Bei schweren Migräneattacken wird die Einnahme eines Triptans empfohlen, eine generelle Präferenz für eine bestimmte Substanz wird hierbei nicht ausgesprochen. Zur medikamentösen Prophylaxe der Migräne werden als Substanzen der ersten Wahl Metoprolol, Propranolol, Flunarizin, Valproinsäure und Topiramat empfohlen. Substanzen der zweiten Wahl sind Amitriptylin, Venlafaxin, Gabapentin, Naproxen, Acetylsalicylsäure, Pestwurz, Magnesium und Vitamin B2. Im Mittelpunkt der nicht medikamentösen Behandlung der Migräne stehen neben Empfehlungen zur Lebensführung, Entspannungsverfahren (progressive Muskelrelaxation), Biofeedbackverfahren und kognitive Verhaltenstherapie. Gerade die Kombination von nicht medikamentösen Verfahren untereinander oder mit einer medikamentösen Prophylaxe ist besonders wirksam.

Summary

The German Migraine and Headache Society and the German Neurological Society present the revised version of their evidence-based guidelines for the treatment of migraine. In the treatment of mild attacks, the early intake of NSAIDs or paracetamol and in severe attacks the intake of a triptan is recommended. There is no general preference for a specific triptan. In the drug prophylaxis of migraine, substances of first choice are metoprolol, propranolol, flunarizine, valproic acid, and topiramate. Substances of second choice are amitriptyline, venlafaxine, gabapentin, naproxen, acetylsalicylic acid, petasites, magnesium, and vitamine B2. Beside advices for life-style, relaxation therapy, biofeedback and cognitive behavioral therapy are the focus of non-drug treatment procedures. In particular, the combination of non-drug therapies among themselves or with a drug prophylaxis are most effective.

Schlüsselwörter

Migräne - Analgetika - Triptane - Prophylaxe - Verhaltenstherapie

Keywords

Migraine - analgesics - triptans - prophylaxis - behavioral therapy
 

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