New AAN Guidelines on Migraine Prevention
The American Academy of Neurology (AAN) and the American Headache Society (AHA) have published new guidelines for the prevention of episodic migraine. The goal was 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?
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.
New Level A changes include the addition of topiramate, but gabapentin and verapamil and other calcium-channel blockers are now considered Level U, or without sufficient evidence for or against their usefulness.
Another evidence-based review evaluated the role of nonsteroidal anti-inflammatory drugs (NSAIDs) and complementary treatments for migraine prevention. They did find sufficient evidence to allow recommendation of some of these treatments.
Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults
Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults