The AAN has published two guidelines that show many pharmaceutical, anti-inflammatory (NSAIDs), and complementary treatments can help prevent migraine attacks in certain people. However, only a minority of people with migraine who are candidates for these preventive treatments actually use them. The guidelines, which were codeveloped by the American Headache Society, were published in the April 24, 2012, issue of Neurology®.
"The strongest evidence we found was for the pharmaceutical treatments divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol, and for frovatriptan for short-term menstrually associated migraine, as well as for the herbal preparation Petasites (butterbur)," said guideline author Stephen D. Silberstein, MD, FACP, FAHS, FAAN. "However, there were several other pharmaceutical and complementary treatments with evidence for use, and still others with evidence against use or with insufficient evidence to make a determination regarding efficacy."
The frequency and severity of migraine attacks can be reduced with preventive treatments. Some studies show that migraine attacks can be reduced by more than half. However, epidemiologic studies suggest that migraine is a condition that is underrecognized and undertreated. "About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only about less than half of these people currently use them," said Silberstein.
Patients using pharmaceutical treatments or those using easily accessible complementary or over-the counter treatments may be unaware of the need for regular follow-up with their doctor, as migraines can worsen or improve, which may require adjusting dosages or changing to another drug.
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