Abortive therapy
There are numerous medications that could be utilized for acute therapy. The initial choice of abortive medication
should be made based on some important aspects of the patient’s condition. The best validated method involves the
principle of ‘‘stratified care.’’ This is a principle in which treatment is based on the patient’s headache characteristics,
including time of peak intensity, severity of the peak pain,associated symptoms, and extent of disability, which can be
measured using the Migraine Disability Assessment [MIDAS]Questionnaire. Migraine is not a disorder for which the same medications will work in every patient, because migraine severity and accompanying disability can be extremely variable among patients and even between attacks in the same patient. The goals of acute treatment, as outlined by the US Headache Consortium are to treat rapidly and consistently without recurrence, restore the ability to function, minimize use of other medications, reduce subsequent use of resources,and be cost-effective with minimal or no side effects. Specific acute treatments for migraine include triptans and ergots, which by definition are effective in migraine and a few select primary headache disorders, but in general do not tend to be effective for other pain disorders.The US Headache Consortium recommends using specific medications for‘‘mild-to-moderate’’ headaches that do not respond to the nonspecific medications or migraines that are moderate to severe in intensity