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How is classic phase 2 migraine managed according to general principles?

  1. Patients in phase 2 migraine should avoid additional serotonin

  2. Patients in phase 2 migraine need serotonin antagonism

  3. Patients in phase 2 migraine need serotonin agonism

  4. Patients in phase 2 migraine will benefit from oxygen therapy

The correct answer is: Patients in phase 2 migraine need serotonin agonism

In managing classic phase 2 migraines, the focus is on the role of serotonin in migraine pathology. During this phase, the body may be experiencing a decrease in serotonin levels, which can contribute to the symptoms associated with migraines. Serotonin agonism, which involves stimulating serotonin receptors to increase serotonin activity, has been shown to alleviate migraine symptoms. By promoting serotonin's action, agonists can lead to vasoconstriction and a reduction in the inflammatory processes that exacerbate a migraine. In contrast, serotonin antagonism, which blocks serotonin receptors, would not address the underlying deficiencies during a classic phase 2 migraine where increased serotonin activity is desirable. Oxygen therapy, although beneficial in certain types of headaches, is not a standard treatment for classic migraines, and avoiding additional serotonin could further aggravate the situation by not addressing the underlying serotonin deficiency. Thus, the choice of serotonin agonism aligns with the physiological needs of patients experiencing classic phase 2 migraines. This understanding of serotonin's role is crucial for effective migraine management.