Evidence-based Guideline Update: Pharmacologic Treatment for Episodic Migraine Prevention in Adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society

Neurology. 2012 Apr 24;78(17):1337-45. doi: 10.1212/WNL.0b013e3182535d20.

Abstract

Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention?

Methods: The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention.

Results and recommendations: The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A).

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anticoagulants / therapeutic use
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Benzimidazoles / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Evidence-Based Medicine
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / prevention & control*
  • Neuroprotective Agents / therapeutic use
  • Parasympatholytics / therapeutic use
  • Tetrazoles / therapeutic use
  • Tryptamines / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticoagulants
  • Anticonvulsants
  • Antidepressive Agents
  • Benzimidazoles
  • Calcium Channel Blockers
  • Carbonic Anhydrase Inhibitors
  • Neuroprotective Agents
  • Parasympatholytics
  • Tetrazoles
  • Tryptamines
  • candesartan