Migraine-preventive medications: ensuring their appropriate use.

OBJECTIVES To emphasize the magnitude and burden of migraine, the need for greater use of migraine-preventive medications in patients who could most benefit from them, and the role that pharmacists can play in migraine prevention. DATA SOURCES PubMed and Medline-based literature searches were conducted to determine the need for migraine-preventive medications, the treatment of migraine, and how pharmacists can assist patients in preventing and treating migraines. The literature search included articles from the previous 6 years, as well as earlier articles for historical perspective. DATA SYNTHESIS Migraine is a prevalent, chronic, neurologic condition that imposes substantial disability on affected patients, leading to a poor quality of life. However, migraine remains underrecognized, underdiagnosed, and under- or suboptimally treated. In particular, migraine-preventive medications are greatly underused, which contributes to avoidable disability. Community pharmacists can play important roles in identifying these and other patients with headache who are in need of medical care, referring appropriate patients to a health care provider, and educating and counseling patients with respect to abortive and preventive medications. CONCLUSION Pharmacists are in a unique position to assist in migraine management, particularly with regard to migraine-preventive medications, because many patients may not be familiar with the benefits and use of these agents. Pharmacist involvement can have a measurable effect on patient care and improve the lives of migraine patients.