Evidence-based guidelines for the pharmacological treatment of migraine

Cephalalgia. 2025 Apr;45(4):3331024241305381. doi: 10.1177/03331024241305381. Epub 2025 Apr 25.

Abstract

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions. The guidelines follow the Grading of Recommendations, Assessment, Development and Evaluation approach for assessing the quality of evidence. The guideline development involved a systematic review of literature across multiple databases, adherence to Cochrane review methods, and a structured framework for data extraction and interpretation. Although the guidelines provide a robust foundation for migraine treatment, they also highlight gaps in current research, such as the paucity of head-to-head drug comparisons and the need for long-term outcome studies. These guidelines serve as a resource to standardize migraine treatment and promote high-quality care across different healthcare settings.

Keywords: acute treatment; drugs; migraine treatment; pharmacological treatments; preventive treatment.

Publication types

  • Systematic Review
  • Practice Guideline

MeSH terms

  • Analgesics* / therapeutic use
  • Evidence-Based Medicine* / standards
  • Humans
  • Migraine Disorders* / drug therapy
  • Randomized Controlled Trials as Topic

Substances

  • Analgesics