Updated guideline issued on migraine prevention medications for adults
To help clinicians determine which medications may be most effective at preventing migraine in adults, the American Academy of Neurology (AAN) and American Headache Society (AHS) have issued a joint practice guideline update with evidence-based recommendations, published in Neurology, and Headache. This update to the AAN and AHS 2012 guideline is endorsed by the American Academy of Family…
The American Academy of Neurology and American Headache Society have issued updated guidelines on preventive medications for adults with migraine. Migraine is a chronic brain disease characterized by headaches and various neurological symptoms that can significantly impact daily functioning. Preventive medications are taken regularly to reduce the frequency and severity of migraine attacks.
The guidelines, published in Neurology and Headache, offer evidence-based recommendations for clinicians to determine which medications may be most effective for adults with migraine. The update includes newer classes of medications released in recent years along with established treatments.
New developments in research have expanded the options available for migraine prevention. The guidelines cover both chronic and episodic migraine, which is defined as having headaches on 15 or more days per month with at least eight days experiencing migraine symptoms.
The guidelines recommend considering preventive treatments for individuals experiencing four or more migraine days monthly, four or more moderate to severe headache days monthly, or if migraine is impairing their ability to work or complete daily tasks. Clinicians should assess the impact of migraine on a person's quality of life when selecting a preventive medication.
Various preventive medications work through different mechanisms, including older medications like antidepressants and blood pressure-lowering drugs, as well as newer medications specifically designed for migraine prevention. Treatment options include oral medications taken daily or every other day, and injectable medications administered monthly or every three months.
After starting a new medication, clinicians should monitor its effectiveness based on the recommended timeframes outlined in the guidelines. The guidelines emphasize that there are numerous effective preventive options, and the choice of medication should consider the strength of the evidence, potential side effects, costs, comorbidities, dosing, and patient preferences.
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