Analgesics and triptans: Still the first choice for migraine.

migraine-related Migraine headaches are usually severe, generally one-sided, and throbbing. Eighty percent of migraine sufferers also experience nausea during an attack, and 50 percent vomit. Tension headaches, on the other hand, are often described by patients as droning and dull, pressing pain; often the entire head and possibly also the shoulder and neck area are affected. Another difference: Migraine headaches worsen with physical activity, while tension headaches often improve with exercise in the fresh air.

The best way to treat migraine headaches has now been reassessed and summarized in the updated S1 guideline "Therapy of Migraine Attacks and Migraine Prophylaxis" by the German Society for Neurology (DGN) and the German Migraine and Headache Society (DMKG). The German Brain Foundation has also created a version of the guideline for patients for the first time.

There are now a number of rapidly effective therapies for acute attacks as well as effective drugs for prophylaxis. "As has become clear, the range of therapies has expanded considerably in recent years, so that there are treatment options for almost all those affected," emphasizes Professor Dr. Hans-Christoph Diener from Essen, in a press release from the DGN.

According to guideline recommendations, mild and moderate migraine attacks should initially be treated with a non-steroidal anti-inflammatory drug (NSAID) such as... Acetylsalicylic acid (ASA) or ibuprofen or the combination of ASA, Paracetamol and Caffeine can be used to treat migraine; all options are effective in treating migraine, the guideline authors emphasize. They are also effective in some patients with severe attacks. The efficacy of ibuprofen and aspirin is best documented; when advising patients in the pharmacy, fast-release formulations such as effervescent or orally disintegrating tablets should be preferred. Generally, for both NSAIDs and triptans, efficacy is higher when taken early in the headache phase.