Paper I
2024 June (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Drugs used in migraine prophylaxis.

Q124 marksShort Answers

Answer

Migraine prophylaxis (used for frequent/disabling attacks, distinct from acute abortive therapy) draws on several drug classes:

  • Beta-blockers (Propranolol) — first-line, reduces attack frequency by an incompletely understood mechanism separate from its cardiovascular action.
  • Tricyclic antidepressants (Amitriptyline, low dose) — particularly useful when migraine coexists with tension-type headache or depression.
  • Anticonvulsants (Sodium valproate, Topiramate) — effective prophylactic agents, mechanism thought related to neuronal excitability suppression.
  • Calcium channel blockers (Flunarizine) — alternative prophylactic option.
  • CGRP monoclonal antibodies (Erenumab) — newer, targeted prophylactic option for refractory cases.

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