Антиепилиптични медикаменти при профилактика на мигрена
Ключови думи :
антиепилептици, мигрена, профилактикаАбстракт
Мигрената е хронично, инвалидизиращо, нелечимо заболяване със значим социално-икономически товар.
Започва и може да продължи като епизодично, но също така и да прогресира, в частност да прерасне в хронична форма. Целите на мигренната профилактика са редукция на честотата, продължителността и тежестта на пристъпите. Допълнителни ползи са потенциране на отговора към симптоматично лечение, функционално подобрение на пациентите, намаление на инвалидизацияна и възпрепятстване на трансформацията от епизодична към хронична форма. Използването на антиепилептични медикаменти за профилактика на мигрена се основава на хипотезата за патофизиоло гични сходства между двете заболявания. Валпроа тите и топирамат са единствените анти епи лептични медикаменти намерили място в ръководствата за лечение. Дозата на медикаментите се титрира бавно до достигане на оптималната и лечението продължава дълго за осъществяване на болест модифициращ ефект. Валпроатите и топирамат са контраиндицирани при бременност. Налице са някои ограничиния при използването им в детска и юношеска възраст.
Необходими са бъдещи проучвания върху антиепилептичните медикаменти с цел по-доброто разбиране на тяхната фармакодинамична активност при мигрена.
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