Мигрень в клинической практике невролога: тернистый путь к рациональной терапии пациентов

Екушева Е.В., Филатова Е.Г. Мигрень в клинической практике невролога: тернистый путь к рациональной терапии пациентов. Consilium Medicum. 2018; 20 (2): 128–135. DOI: 10.26442/2075-1753_2018.2.128-135

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Ekusheva E.V., Filatova E.G. Migraine in the clinical practice of a neurologist: a thorny path to rational therapy of patients. Consilium Medicum. 2018; 20 (2): 128–135. DOI: 10.26442/2075-1753_2018.2.128-135

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Аннотация

Мигрень отличается высокой дезадаптацией и существенным снижением качества жизни пациентов в связи с частотой, длительностью и тяжестью приступов головной боли. Несмотря на широкую распространенность заболевания, путь от постановки диагноза, до подбора эффективной терапии и значимого улучшения качества жизни больных с мигренью порой занимает много лет. Этот вариант первичной головной боли отличается выраженным полиморфизмом приступов, и совсем непросто выбрать оптимальное средство для купирования боли. Наиболее эффективные селективные агонисты 5НТ1В/1D-рецепторов серотонина (триптаны) недостаточно часто применяются даже у больных с тяжелыми и длительными приступами; не все пациенты осведомлены об их существовании или не удовлетворены их эффектом, что нередко связано с неправильным применением препаратов во время мигренозного приступа. В этой связи предметом активного исследования продолжает оставаться изучение средств из группы триптанов, являющихся наиболее эффективными, патогенетически обоснованными препаратами для терапии мигренозных атак. Анализ клинического применения отечественного препарата Мигрепам® (золмитриптан) для купирования приступов мигрени без ауры продемонстрировал его высокую эффективность, хорошую переносимость и безопасность, а также значительную приверженность пациентов терапии препаратом Мигрепам® в дальнейшем.

Ключевые слова: мигрень, триптаны, золмитриптан, Мигрепам.

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Migraine is characterized by high disadaptation and a significant decrease in the quality of life of patients due to the frequency, duration and severity of attacks of headache. Despite the wide prevalence of the disease, the path from diagnosis, selection of effective therapy and significant improvement in the quality of life of patients with migraine sometimes takes many years. This variant of primary headache is distinguished by a significant polymorphism of attacks of cephalalgia, and it is not at all easy to choose the optimal means for relief of pain. The most effective selective agonists of 5HT1B/1D receptors of serotonin (triptans) are not often used even in patients with severe and prolonged attacks, not all patients are aware of their existence or are not satisfied with their effect, which is often associated with improper use of drugs during a migraine attack. In this connection, the study of funds from the group of triptans, which are the most effective, pathogenetically substantiated drugs for the therapy of migraine attacks, continues to be the subject of active research. Analysis of the clinical use of the domestic drug Migrepam® (zolmitriptan) for arresting migraine attacks without an aura demonstrated its high efficacy, good tolerability and safety, and also the high adherence of patients to Migrepam® therapy in the future.

Key word: migraine, triptans, zolmitriptan, Migrepam.

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