(RxWiki News) Migraines can be such a headache. Luckily, many migraine treatments work.
A new study from the American Headache Society found that triptans, dihydroergotamine, nonsteroidal anti-inflammatory drugs (NSAIDs) and combination medications treated migraines most effectively.
Although opioids were likely to be effective, the authors of this study did not recommend them for regular use.
"In my practice I have seen patients who have received opiate pain medicaiton for acute migraine pain treatment. These patients tend to follow a pattern of increased frequency of headaches along with a corresponding increase in opiate prescriptions," said Steve Leuck, PharmD, a pharmacist and President of AudibleRx.
"Patients who experience two or more migraines per month, on a regular basis, should discuss with their physician the option of prophylactic (preventive) treatment," said Dr. Leuck, who was not involved in this study. "In my opinion, many individuals who suffer migraines may decrease their incidence of headaches if they were taking one of the medications indicated for migraine prophylaxis."
Michael J. Marmura, MD, of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia, PA, led this study.
“This review focuses on the treatment of acute migraine attacks, rather than long-term outcomes,” Dr. Marmura said in a press release. “Clinicians still need to individualize treatment and consider the clinical context of the migraine attack.”
Dr. Marmura and team reviewed 132 studies on treatments for severe migraines. These trials were published between 1998 and 2013.
These researchers rated each study based on its quality. Based on that quality rating, the medications in the study were classified as being effective, probably effective, possibly effective, or that there was conflicting or not enough evidence to support the medication.
Dr. Marmura and team found that triptans were effective treatments for migraines. Triptans are a class of medications that includes almotriptan (brand name Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt) and sumatriptan (Imitrex).
Effective migraine treatments also included NSAIDs, Dr. Marmura and team found. NSAIDs include aspirin (Ecotrin), diclofenac (Voltaren), ibuprofen (Advil and Motrin), naproxen (Aleve) and butorphanol nasal spray (Stadol).
Other effective migraine treatments included acetaminophen (Tylenol), dihydroergotamine (D.H.E. 45 and Migranal) and combinations of medications, such as acetaminophen combined with aspirin and caffeine.
Dr. Marmura and team noted that a treatment isn't necessarily the best for each patient just because it had been deemed effective.
“This evidence base for medication efficacy should be considered along with potential medication side effects, potential adverse events, patient-specific [potential problems with taking] a particular medication, and drug-to-drug interactions when deciding which medication to prescribe for acute therapy of a migraine attack,” Dr. Marmura and team wrote.
This study was published Jan. 20 in the journal Headache.
The American Headache Society funded this research. Study authors Drs. Marmura and Todd J. Schwedt received royalty income and/or consulting fees from private sources. Study author Dr. Stephen D. Silberstein received consulting fees from pharmaceutical companies.
