Purpose of Review

Migraine headaches are a neurologic disorder characterized by attacks of moderate to severe throbbing headache that are typically unilateral, exacerbated by physical activity, and associated with phonophobia, photophobia, nausea, and vomiting. In the USA, the overall age-adjusted prevalence of migraine in female and male adults is 22.3% and 10.8%, respectively.

Recent Findings

Migraine is a disabling disease that ranks as the 8th most burdensome disease in the world and the 4th most in women. The overarching hypothesis of migraine pathophysiology describes migraine as a disorder of the pain modulating system, caused by disruptions of the normal neural networks of the head. The activation of these vascular networks results in meningeal vasodilation and inflammation, which is perceived as head pain. The primary goals of acute migraine therapy are to reduce attack duration and severity. Current evidence-based therapies for acute migraine attacks include acetaminophen, four nonsteroidal anti-inflammatory drugs (NSAIDs), seven triptans, NSAID–triptan combinations, dihydroergotamine, non-opioid combination analgesics, and several anti-emetics.

Summary

Over-the-counter medications are an important component of migraine therapy and are considered a first-line therapy for most migraineurs. These medications, such as acetaminophen, ibuprofen, naproxen, and aspirin, have shown strong efficacy when used as first-line treatments for mild-to-moderate migraine attacks. The lower cost of over-the-counter medications compared with prescription medications also makes them a preferred therapy for some patients. In addition to their efficacy and lower cost, over-the-counter medications generally have fewer and less severe adverse effects, have more favorable routes of administration (oral vs. subcutaneous injection), and reduced abuse potential. The purpose of this review is to provide a comprehensive evidence-based update of over-the-counter pharmacologic options for chronic migraines.

中文翻译：

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慢性偏头痛的非处方治疗的全面综述。

审查目的

偏头痛是一种神经系统疾病，其特征为中度至重度搏动性头痛发作，通常为单侧发作，由于体育活动而加剧，并伴有恐惧症，畏光，恶心和呕吐。在美国，按年龄调整的偏头痛的总体患病率分别为女性和男性，分别为22.3％和10.8％。

最近的发现

偏头痛是一种致残性疾病，在世界上排名第8的繁重疾病中，在女性中排名第4。偏头痛病理生理学的最主要假设将偏头痛描述为疼痛调节系统的一种疾病，由头部正常神经网络的破坏引起。这些血管网络的激活导致脑膜血管舒张和发炎，这被认为是头痛。急性偏头痛治疗的主要目标是减少发作持续时间和减轻严重程度。当前用于急性偏头痛发作的循证疗法包括对乙酰氨基酚，四种非甾体类抗炎药（NSAID），七种曲普坦，NSAID-曲普坦组合，二氢麦角胺，非阿片类镇痛药和几种止吐药。

概要

非处方药是偏头痛治疗的重要组成部分，被认为是大多数偏头痛患者的一线治疗方法。这些药物（如对乙酰氨基酚，布洛芬，萘普生和阿司匹林）用作轻度至中度偏头痛发作的一线治疗药物时，已显示出强大的功效。与处方药相比，非处方药的成本较低，这使得它们成为某些患者的首选疗法。除了它们的功效和较低的成本外，非处方药通常具有越来越少的严重不良反应，具有更有利的给药途径（口服与皮下注射），并减少了滥用的可能性。这篇综述的目的是为慢性偏头痛的非处方药提供全面的循证更新。