Although several preventive migraine treatments are very effective for many patients, few sufferers use them, according to new American Academy of Neurology guidelines. The guidelines have been published in the journal Neurology and will be presented tomorrow at the American Academy of Neurology’s 64th Annual meeting in New Orleans.

Author Stephen D. Silberstein, MD, FACP, FAHS, of Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow of the American Academy of Neurology, said:

“Studies show that migraine is underrecognized and undertreated. About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them.”

Preventive treatments are generally administered daily to prevent migraine attacks from ever occurring, or to lessen their severity and length of duration if they do.

Silberstein said:

“Some studies show that migraine attacks can be reduced by more than half with preventive treatments.”

All evidence related to migraine prevention was reviewed before the guidelines were made.

The following prescription medications were found to be effective in preventing migraine attacks, or at least reducing their severity and/or duration:

  • divalproex sodium (a seizure medication)
  • sodium valproate (a seizure medication)
  • topiramate (a seizure medication)
  • metoprolol (beta blocker)
  • propranolol (beta blocker)
  • timolol (beta blocker)

The guidelines say that doctors should offer these medications for the prevention or reduction in frequency or severity of migraine attacks.

The guidelines say that Lamotrigine, a seizure medication, does not prevent migraine.

According to the guideline, herbal preparation Petasites (butterbur) can effectively prevent migraine attacks.

The following were also found to be effective:

    NSAIDs (nonsteroidal anti-inflammatory drugs)

  • Fenoprofen
  • Ibuprofen
  • Ketoprofen
  • Naproxen and naproxen sodium
  • Subcutaneous histamine
  • Complementary treatments

  • Magnesium
  • MIG-99 (feverfew)
  • Riboflavin

Even though patients do not require a prescription for these OTC medications and complementary therapies, Dr. Silberstein said that patients should still visit their doctor for their scheduled follow-up appointments.

Silberstein said:

“Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication. In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side effects or interact with other medications, which should be monitored.”

Written by Christian Nordqvist