The Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies

  title={The Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies},
  author={Michael J Marmura and Stephen D. Silberstein and Todd J. Schwedt},
  journal={Headache: The Journal of Head and Face Pain},
The study aims to provide an updated assessment of the evidence for individual pharmacological therapies for acute migraine treatment. [] Key Method A standardized literature search was performed to identify articles related to acute migraine treatment that were published between 1998 and 2013. The American Academy of Neurology Guidelines Development procedures were followed. Two authors reviewed each abstract resulting from the search and determined whether the full manuscript qualified for review.

How to Apply the AHS Evidence Assessment of the Acute Treatment of Migraine in Adults to your Patient with Migraine

Advice is provided on how to choose between evidence‐based treatment options, and on designing an individualized strategy for managing migraine attacks, based on the clinical characteristics of the patient and their migraine attacks.

Acute Treatment of Migraine

The acute management of migraine should incorporate a stratified care model in concert with evidence-based treatment options, and measures should be taken to identify suboptimal tolerability or efficacy.

Headache in Children and Adolescents

The approach to a child or adolescent with headache, the criteria for common diagnoses, and the evidence base for treatments are reviewed, as well as the questions that should be addressed in future research are outlined.

An Evaluation of Medication Prescribing Patterns for Acute Migraine in the Emergency Department: A Scoping Review

Treatment practices for acute migraine in the ED are heterogeneous and deviate from established international recommendations, with particular attention placed on opioids and migraine specific therapy.

Treatment of migraine: a review of disease burden and an update on the therapeutic landscape for pharmacists

The burden of migraine, recent advances in preventive migraine therapies, and key takeaways from the most recent migraine management consensus statement are highlighted.

Recent advances in migraine therapy

Preclinical and clinical data on compounds acting on calcitonin gene-related peptide or its receptor, the serotonin 5-HT1F receptor, nitric oxide synthase, and acid-sensing ion channel blockers are discussed.

The current state of acute treatment for migraine in adults in the United States

The objective of this narrative review is to familiarize primary care clinicians with the variety of acute treatment options available in the United States today based on clinical trial findings, meta-analyses, evidence-based guidelines, and professional society consensus statements.

An Evidence-Based Review of Fremanezumab for the Treatment of Migraine

This review provides an update on the epidemiology, pathogenesis, diagnosis, and current treatment of migraine, and summarizes the evidence for fremanezumab as a treatment for migraine.

Acute Migraine Treatment

This article discusses acute migraine therapy, focusing on best-level evidence, and focuses on migraine-specific pathways to allow for precise care with fewer side effects.

Preventing the Progression of Episodic Migraine to Chronic Migraine with Acute Treatment Optimization

This review presents the existing data about acute treatment optimization and its preventive role in the progression of episodic migraine to chronic migraine and review the evidence for acute migraine treatments currently available in clinical practice.



Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review)

This practice parameter summarizes the results from the four evidence-based reviews on the management of patients with migraine: specifically, acute, preventive, and nonpharmacologic treatments for migraine, and the role of neuroimaging in patients with headache.

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults

New evidence-based recommendations for the preventive treatment of migraine headache are provided and petasites (butterbur) is effective for migraine prevention and should be offered to patients with migraine to reduce the frequency of migraine attacks.

Practice Parameter: Pharmacological treatment of migraine headache in children and adolescents

For children (>age 6 years), ibuprofen is effective and acetaminophen is probably effective and either can be considered for the acute treatment of migraine, and for adolescents (>12 years of age), sumatriptan nasal spray iseffective and should be consideredfor the acute Treatment of migraine.

Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study.

Acetaminophen was highly effective for treating pain, functional disability, photophobia, and phonophobia in a population-based sample of people with migraine, excluding the most disabled persons with migraine.

Rizatriptan for the Acute Treatment of ICHD-II Proposed Menstrual Migraine: Two Prospective, Randomized, Placebo-Controlled, Double-Blind Studies

Rizatriptan 10 mg was effective for the treatment of ICHD-II menstrual migraine, as measured by 2-h pain relief and 24-h sustained pain relief.

Octreotide is not Effective in the Acute Treatment of Migraine

Modelling the headache response as a binomial determined by treatment, using the patient as the level 2 variable, and considering a possible period effect, and sex and migraine type as other variables of interest, subcutaneous octreotide was not significantly superior to placebo.

Safety and efficacy of intravenous sodium valproate in the treatment of acute migraine.

The results confirm the therapeutic value of intravenous Valproate in acute migraine attacks described in literature and show a beneficial effect on all investigated efficacy parameters with a trend to even better response in patients receiving valproate prophylaxis.

Speed of Onset, Efficacy and Tolerability of Zolmitriptan Nasal Spray in the Acute Treatment of Migraine

Zolmitriptan nasal spray is highly effective in the acute treatment of migraine and has a very fast onset of action, producing significant headache response and pain-free rates as early as 15 minutes post-dose (the earliest assessment in this study).

No effect of eletriptan administration during the aura phase of migraine

This study confirms the findings of two studies showing that triptans are ineffective but safe when given during the migraine aura phrase, and eletriptan was well tolerated and did not prolong the aura phase.