AAN Prevention Summary
Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults by the American Academy of Neurology (2012)
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Summary:
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RECOMMENDATIONS
Level A.
The following medications are established as effective and should be offered for migraine prevention:
Antiepileptic drugs (AEDs): divalproex sodium, sodium valproate, topiramate
β-Blockers: metoprolol, propranolol, timolol
Triptans: frovatriptan for short-term MAMs prevention
Level B.
The following medications are probably effective and should be considered for migraine prevention:
Antidepressants: amitriptyline, venlafaxine
β-Blockers: atenolol, nadolol
Triptans: naratriptan, zolmitriptan for short-term MAMs prevention
Level C.
The following medications are possibly effective and may be considered for migraine prevention:
ACE inhibitors: lisinopril
Angiotensin receptor blockers: candesartan
α-Agonists: clonidine, guanfacine
AEDs: carbamazepine
β-Blockers: nebivolol, pindolol
Level U.
Evidence is conflicting or inadequate to support or refute the use of the following medications for migraine prevention:
AEDs: gabapentin
Antidepressants
Selective serotonin reuptake inhibitor/selective serotonin-norepinephrine reuptake inhibitors: fluoxetine, fluvoxamine
Tricyclics: protriptyline
Antithrombotics: acenocoumarol, Coumadin, picotamide
β-Blockers: bisoprolol
Calcium-channel blockers: nicardipine, nifedipine, nimodipine, verapamil
Acetazolamide
Cyclandelate
Level A negative.
The following medication is established as ineffective and should not be offered for migraine prevention:
Lamotrigine
Level B negative.
The following medication is probably ineffective and should not be considered for migraine prevention:
Clomipramine
Level C negative.
The following medications are possibly ineffective and may not be considered for migraine prevention:
Acebutolol
Clonazepam
Nabumetone
Oxcarbazepine
Telmisartan