New guidelines for the management of migraine in primary care
Humans; Questionnaires; Medical History Taking; Primary Health Care; Non-U.S. Gov't; Research Support; patient care team; referral and consultation; algorithms; Diagnosis; Differential; Patient Education; Migraine Disorders/diagnosis/prevention & control/therapy
Despite repeated initiatives over the past decade, migraine remains under-recognised, under-diagnosed and under-treated in everyday clinical practice. The Migraine in Primary Care Advisors (MIPCA) group has produced new guidelines for migraine management to attempt to rectify this situation. MIPCA is a group of physicians, nurses, pharmacists and other healthcare professionals dedicated to the improvement of headache management in primary care, who have also worked closely with the Migraine Action Association (the UK patients' group) in the development of these guidelines. The principles of the new MIPCA guidelines are: To arrange specific consultations for headache. To institute a system of detailed history taking, patient education and buy-in at the outset of the consultation. To utilise a new screening algorithm for the differential diagnosis of headache, which can be confirmed by further questioning, if necessary. To institute a process of management that is individualised for each patient, using a new algorithm. Assessing the impact on the patient's daily life is a key aspect of diagnosis and management. To prescribe only treatments that have objective evidence of favourable efficacy and tolerability. To utilise prospective follow-up procedures to monitor the success of treatment. To organise a team approach to headache management in primary care.
2002
Dowson AJ; Lipscombe S; Sender J; Rees T; Watson D; Migraine In Primary Care Advisors (MIPCA) - Migraine Guidelines Development Group
Current Medical Research And Opinion
2002
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1185/030079902125001164" target="_blank" rel="noreferrer">10.1185/030079902125001164</a>
Focus on paroxetine
Humans; Treatment Outcome; Drug Interactions; Animals; Antidepressive Agents; Stress Disorders; Anxiety Disorders/drug therapy; Depression/drug therapy; Paroxetine/administration & dosage/adverse effects/pharmacokinetics/therapeutic use; Post-Traumatic/drug therapy; Second-Generation/administration & dosage/adverse effects/pharmacokinetics/therapeutic use; Serotonin Uptake Inhibitors/administration & dosage/adverse effects/pharmacokinetics/therapeutic use; Substance Withdrawal Syndrome
This review of paroxetine is based on Medline and PsycLit searches and a manual search of the available research literature. It aims to cover the pharmacology of this frequently prescribed SSRI antidepressant in terms of its indications, efficacy and adverse effects. Overall, paroxetine is a well-tolerated and safe first-line SSRI antidepressant with anxiolytic qualities. It has been found useful in depression, anxiety and other conditions such as obsessive compulsive disorder and post-traumatic stress disorder. The antidepressant has some advantages over earlier tricyclic medication in terms of a lack of cardiovascular side-effects and relative safety in overdose. Cessation of use, however, is associated with withdrawal or discontinuation symptoms and patients should be counselled as to how these might be avoided. A 3- or 4-week graded withdrawal regimen, perhaps with concomitant fluoxetine to cover serotonergic discontinuation symptoms, may be advisable.
2003
Green B
Current Medical Research And Opinion
2003
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1185/030079902125001353" target="_blank" rel="noreferrer">10.1185/030079902125001353</a>