Acute Migraine Medications and Evolution From Episodic to Chronic Migraine: A Longitudinal Population‐Based Study

This study explores how acute migraine medications affect the transition from episodic migraine (EM) to chronic migraine (TM). Researchers followed 8219 EM patients over five years. They found that 2.5% developed TM within a year. The study adjusted for factors like gender, headache frequency, and medication use. Using barbiturates significantly raised the risk of developing TM, with an odds ratio of 2.06. Opiate users also had an increased risk, with an odds ratio of 1.98. Interestingly, triptan use did not show any association with TM risk. Non-steroidal anti-inflammatory drugs (NSAIDs) had a complex role. They were protective against TM for those with lower headache frequencies. However, at high headache frequencies, NSAIDs increased TM risk. These findings highlight the importance of medication choice among EM patients to prevent progression to TM. Understanding medication impact can help manage migraine effectively. Clinical relevance: This research suggests certain acute migraine medications may influence the transition to chronic migraine, emphasizing careful medication management for patients.