Migraine

Migraine mainly affects young adults and is more prevalent in females.1,2 Global research by WHO classifies severe migraine as being comparable with the most disabling of illnesses.3 This research suggests that regular migraines are as disabling as dementia, quadriplegia and active psychosis.3

Treatment goals for migraine include rapid and consistent relief without recurrence, restoring ability to function, minimizing the use of rescue medication, optimizing self-care to minimize the use of resources, cost efficacy for overall management and minimal or no adverse events.4,5

The pharmacological treatment approach is divided into acute (to relieve a migraine attack) and preventative (to reduce the frequency, duration and intensity of attacks).4,6 It is important that patients understand the reasons for and differences between these two approaches and that the medications used for each are used very differently.4

Migraine does not fall under prescribed minimum benefits in South Africa so medication costs fall to the patient,7 highlighting the need for high-quality generic migraine treatments.

References
1.

Steiner TJ, Stovner LJ, Vos T. GBD 2015: Migraine is the Third Cause of Disability in Under 50s. The Journal of Headache and Pain. 2016;17(1):104. doi:10.1186/s10194-016-0699-5

2.

Steiner T, Scher A, Stewart W, et al. The Prevalence and Disability Burden of Adult Migraine in England and Their Relationships to Age, Gender and Ethnicity. Cephalalgia. 2003;23(7):519-527. doi:10.1046/j.1468-2982.2003.00568.x

3.

Menken M, Munsat TL, Toole JF. The Global Burden of Disease Study: Implications for Neurology. Arch Neurol. 2000;57(3):418. doi:10.1001/archneur.57.3.418

4.

Ong JJY, De Felice M. Migraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action. Neurotherapeutics. 2018;15(2):274-290. doi:10.1007/s13311-017-0592-1

5.

Silberstein SD. Practice Parameter: Evidence-Based Guidelines for Migraine Headache (an Evidence-Based Review): Report of the Quality Standards Subcommittee of the American Academy Of Neurology. Neurology. 2000;55(6):754-762. doi:10.1212/WNL.55.6.754

6.

Agostoni EC, Barbanti P, Calabresi P, et al. Current and Emerging Evidence-Based Treatment Options in Chronic Migraine: A Narrative Review. J Headache Pain. 2019;20(1):92. doi:10.1186/s10194-019-1038-4

7.

Council for Medical Schemes. Prescribed Minimum Benefits and Chronic Medication [Online]. Cited 12 Jun 2020. Available from: https://www.hfassociation.co.za/images/members-resources/PMB_ConsumerGuideBookLet.pdf