AAN Prevention Summary

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults by the American Academy of Neurology (2012)

Full article:

• http://www.neurology.org/content/78/17/1337.full

Summary:

Text Box

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