Managing migraine in special populations

Older people

• Secondary headache, comorbidities and adverse events are all more likely
• Poor evidence base for all drugs in this age group

Children and adolescents

• Be aware that presentation can differ from migraine in adults
• Parents and schools have important roles in the

management of young children

• Bed rest alone can be sufficient
• Use ibuprofen for acute treatment and propranolol, amitriptyline or topiramate for prevention

Women who are pregnant or breastfeeding

• Use paracetamol for acute treatment
• Avoid preventive treatment if possible

Women with menstrual migraine

• Perimenstrual preventive therapy with long-acting NSAID or triptan