National Guideline Clearinghouse | EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force.

Guideline Title
EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force.

Bibliographic Source(s)
Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sandor PS, European Federation of Neurological Societies. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol 2009 Sep;16(9):968-81. [215 references] PubMed

Guideline Status
This is the current release of the guideline.

This guideline updates a previous version: Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sandor PS. EFNS guideline on the drug treatment of migraine - report of an EFNS task force. Eur J Neurol 2006 Jun;13(6):560-72.

These recommendations should be updated within 3 years and should be complemented by recommendations for the non-drug treatment of migraine.

full-text:
National Guideline Clearinghouse | EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force.






Eur J Neurol. 2009 Sep;16(9):968-81.
EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force.
Evers S, Afra J, Frese A, Goadsby PJ, Linde M, May A, Sándor PS; European Federation of Neurological Societies.
SourceDepartment of Neurology, University of Münster, Münster, Germany.
everss@uni-muenster.de


Abstract
BACKGROUND: Migraine is one of the most frequent disabling neurological conditions with a major impact on the patients' quality of life.

OBJECTIVES: To give evidence-based or expert recommendations for the different drug treatment procedures in the particular migraine syndromes based on a literature search and the consensus of an expert panel.

METHODS: All available medical reference systems were screened for the range of clinical studies on migraine with and without aura and on migraine-like syndromes. The findings in these studies were evaluated according to the recommendations of the European Federation of Neurological Societies (EFNS) resulting in level A, B, or C recommendations and good practice points.

RECOMMENDATIONS: For the acute treatment of migraine attacks, oral non-steroidal antiinflammatory drug (NSAID) and triptans are recommended. The administration should follow the concept of stratified treatment. Before intake of NSAID and triptans, oral metoclopramide or domperidone is recommended. In very severe attacks, intravenous acetylsalicylic acid or subcutaneous sumatriptan are drugs of first choice. Status migrainosus can be treated by cortoicosteroids, although this is not universally held to be helpful, or dihydroergotamine. For the prophylaxis of migraine, betablockers (propranolol and metoprolol) flunarizine, valproic acid, and topiramate are drugs of first choice. Drugs of second choice for migraine prophylaxis include amitriptyline, naproxen, petasites, and bisoprolol.

PMID:19708964[PubMed - indexed for MEDLINE]
EFNS guideline on the drug treatment of migraine--... [Eur J Neurol. 2009] - PubMed result