AAN: Recommendations for Migraine Prevention Issued

Frequency and severity of migraine attacks can be reduced using seizure drugs and beta-blockers

MONDAY, April 23 (HealthDay News) -- Several pharmaceutical treatment strategies are available for migraine prevention, according to an evidence-based guideline update published in the April 24 issue of Neurology to coincide with presentation at the annual meeting of the American Academy of Neurology, held from April 21 to 28 in New Orleans.

Stephen D. Silberstein, M.D., of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia, and colleagues reviewed evidence from studies published from June 1999 to May 2009 on the efficacy of various medications available in the United States for migraine prevention.

Based on a review of 29 Class I or II articles selected from a review of 284 abstracts, the authors made several recommendations based on Level A evidence. Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol effectively prevent migraine and should be offered to patients to reduce the frequency and severity of migraine attacks. Menstrual migraine can be effectively prevented with frovatriptan. Lamotrigine was found to be ineffective for preventing migraines.

"Evidence to support pharmacologic treatment strategies for migraine prevention indicates which treatments might be effective but is insufficient to establish how to choose an optimal therapy," the authors write. "Treatment regimens, therefore, need to be designed case by case, which may include complex or even nontraditional approaches."

Several authors disclosed financial ties to the pharmaceutical industry.

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