Headache diagnoses are based on the international classification of headache disorders ; 2nd edition (ICHD-II). In Japan, migraine management is practiced using the Japanese guideline for primary headache. There are many acute and preventive migraine treatments. The triptans, selective serotonin 5-HT
1B/1D agonists, are specific acute migraine drugs ; five brands including sumatriptan, zolmitriptan, eletriptan, rizatriptan and naratriptan are presently available in Japan. We can also choose from tablet, oral, nasal or hypodermal injection administraction. To obtain satisfactory results with triptans, proper diagnosis and early intervention before cutaneous allodynia emerges are required. Because frequent use of triptans for more than ten days a month over a three month period may evoke medication overuse headache, increased headache frequency is an indication for preventive treatment.
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