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