The AAN Migraine Report
Migraines can be extremely difficult to treat and their physiologic etiology remains unknown. Many patients suffer from migraines quite often (10 times or more a month). Here’s the latest direction, evidence based, for choosing migraine medications.
In the April 24th issue of Neurology, two new reviews were released by the American Academy of Neurology (AAN) regarding the treatment of episodic migraines. The first reviewed the evidence for prescription strength medications and the second reviewed the use of non-steroidal anti-inflammatory meds as well as complementary medications.
There were seven medications that were considered effective (meaning they had to have at least 2 trials that were randomized and considered high quality, and found to have a statistically significant improvement in symptoms). These meds included:
These medications include three anti-epileptic meds (AEDs), three beta blockers and one triptan. Interestingly, Gabapentin and verapamil used to be considered first line agents but they have been downgraded as studies have not proven their effectiveness.
For the second review, only one treatment option was found to warrant approval. This is Petasites, also known as butterbur. It is a plant in the daisy family.
There are many other treatment options, but currently only these 8 items have the evidence to support their recommendation for first line use. Of course, other options can and should be looked at when these items do not work or are not appropriate for one reason or another, including Botox®, ibuprofen, naproxen, and verapamil, just to name a few.
- There’s a Role for Compounding Pharmacies
- Complex Regional Pain Syndrome
- The cost of pain
- The AAN Migraine Report
- Opioid Medications as Front Page News
- Veterans and Opioid Use
- The Surgeon General's Technology Report
- Change is Never Easy
- Looking at Kidney Stones
- Chronic Pain Management: There’s an App for Everything
- Pain is the Fifth Vital Sign
- Cannabis in Combination Therapy?
- Pain and Diabetes: This is Only the Beginning
- The Claim: The new formulation of OxyContin® is going to do more harm than good
- MRI: The Need and the Expectation
- Speaking of Combination Therapy
- The Truth About Acupuncture
- An Interview with Harry Leider, MD of Ameritox, Ltd.
- The Recall of Tylenol®
- Another Look at Gout
- Massage as Therapy: A Look at the Evidence
- Michelle Bachmann and Migraine Awareness
- ...And Washington State Weighs In
- Opioid Prescribing in Ohio
- Opioid-Induced Constipation
- Pain Management Education