mx of migraine

The management of migraine includes both acute and prophylactic treatments. For acute treatment, consider combination therapy with an oral triptan and an NSAID, or an oral triptan and paracetamol, tailored to the person's preferences and medical history. Monotherapy with an oral triptan, NSAID, aspirin, or paracetamol can also be considered. If oral or nasal preparations are ineffective or not tolerated, non‑oral options like metoclopramide or prochlorperazine may be used, with additional considerations for adding NSAIDs or triptans. Preventive treatments include topiramate or propranolol, after a full discussion of benefits and risks, especially considering pregnancy and contraception. Other options include amitriptyline or acupuncture if first-line prophylactics are unsuitable. Regular review of prophylaxis is recommended after 6 months, and ongoing management should be tailored to individual needs and preferences.