American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which treatment is not typically used for treating acute migraine without aura?

Triptans
NSAIDs
Dihydroergotamine
Antipsychotics

The correct answer is: Antipsychotics

In the treatment of acute migraine without aura, the use of triptans, NSAIDs, and dihydroergotamine is well-established. Triptans are specifically designed to target migraine pathways by agonizing serotonin receptors, leading to vasoconstriction and reduced inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly employed for their analgesic and anti-inflammatory properties, providing symptom relief. Dihydroergotamine is a vasoconstrictor that can be effective in aborting a migraine attack. Antipsychotics, while useful in certain psychiatric conditions, do not have a recognized role in the management of migraines. They do not address the underlying pathophysiology of a migraine attack and hence are not utilized for the acute management of this condition. Their primary actions are related to treating disorders like schizophrenia or bipolar disorder rather than providing acute headache relief. Therefore, the option of antipsychotics stands out as the treatment that does not align with standard practice for acute migraine without aura.