General Issues Arising from the Use of Drugs for Headache Disorders

  • Peer Carsten Tfelt-Hansen
  • Koen Paemeleire
Reference work entry


The WHO’s list of essential medicines for migraine only includes paracetamol, aspirin, ibuprofen, and propranolol at present. In the past few years, Lifting The Burden has been striving to include triptans as a group. It is a clinical reality indeed that patients may not respond to analgesics and NSAIDs, but may be triptan-responders. The benefit-to-tolerability ratio of triptans favors oral triptans in acute migraine treatment, but we illustrate why subcutaneous sumatriptan is the triptan of choice in acute cluster headache treatment. The individual response to prophylactic treatment is quite variable, based on individual pharmacokinetic and pharmacodynamic differences. Tailoring of drugs to patients is important in clinical practice. Barriers to optimal drug treatment of headache disorders include undertreatment and mismanagement, despite existing guidelines. Medication-overuse headache has been described in a number of headache disorders, but is most commonly encountered in migraine patients.


Cluster Headache Migraine Patient Headache Disorder Ergot Alkaloid Cluster Headache Patient 
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Copyright information

© Lifting The Burden 2011

Authors and Affiliations

  1. 1.Danish Headache Centre and Department of NeurologyGlostrup Hospital, University of CopenhagenGlostrupDenmark
  2. 2.Department of NeurologyGhent University HospitalGhentBelgium

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