Summary of AAN-AHS Guidelines on Preventive Therapies for Episodic Migraine

Table 1. Summary of AAN-AHS Guidelines on Preventive Therapies for Episodic Migraine1,2

Status

Therapies

Established to be effective

  • AEDs: divalproex sodium, sodium valproate, topiramate
  • Beta-blockers: metoprolol, propranolol, timolol
  • Triptans: frovatriptan for short-term MAM prevention
  • CAM: petasites (butterbur)

Probably effective

  • Antidepressants: amitriptyline, venlafaxine
  • Beta-blockers: atenolol, nadolol
  • Triptans: naratriptan, zolmitriptan for short-term MAM prevention
  • NSAIDs: fenoprofen, ibuprofen, ketoprofen, naproxen, naproxen sodium
  • CAM: riboflavin, magnesium, MIG-99 (feverfew)
  • Histamines: histamine subcutaneous

Possibly effective

  • Angiotensin-converting enzyme inhibitors: lisinopril
  • Angiotensin receptor blockers: candesartan
  • Alpha-agonists: clonidine, guanfacine
  • AEDs: carbamazepine
  • Beta-blockers: nebivolol, pindolol
  • NSAIDs: flurbiprofen, mefenamic acid
  • CAM: Co-Q10, estrogen
  • Antihistamines: cyproheptadine

Neither supported or refuted by existing data

  • AEDs: gabapentin
  • Antidepressants: fluoxetine, fluvoxamine, protriptyline
  • Antithrombotics: acenocoumarol, warfarin, picotamide
  • Beta-blockers: bisoprolol
  • Calcium-channel blockers: nicardipine, nifedipine, nimodipine, verapamil
  • Acetazolamide
  • Cyclandelate
  • NSAIDs: aspirin, indomethacin
  • CAM: omega-3, hyperbaric oxygen

Possibly ineffective

  • Acebutolol
  • Clonazepam
  • Nabumetone
  • Oxcarbazepine
  • Telmisartan

Probably ineffective

  • Clomipramine
  • Montelukast

Established to be ineffective

  • Lamotrigine

References

  1. Silberstein SD, Holland S, Freitag F, et al.; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. [reaffirmed on July 18, 2015]. Neurology. 2012;78:1337-1345. Abstract
  2. Holland S, Silberstein SD, Freitag F, et al.; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1346-1353. Abstract
Last modified: May 8, 2017