The Acute Treatment of Migraine in Adults: The <scp>A</scp> merican <scp>H</scp> eadache <scp>S</scp> ociety Evidence Assessment of Migraine Pharmacotherapies

This study reviews evidence for medications used to treat acute migraine attacks. It updates previous guidelines from the American Academy of Neurology published in 2000. A comprehensive literature search identified articles about acute migraine treatments from 1998 to 2013. Two authors evaluated abstracts to select full manuscripts for review. Each qualifying manuscript was analyzed for its level of evidence. Level A evidence indicates strong support, while Level B shows probable effectiveness. Effective medications include triptans, dihydroergotamine, acetaminophen, and nonsteroidal anti-inflammatory drugs, all classified as Level A. Some medications, such as ketorolac and antiemetics, are likely effective, categorized as Level B. There’s inadequate evidence for certain treatments like butalbital and corticosteroids, categorized as Level C. Clinicians should weigh medication effectiveness against potential side effects when treating migraines. Opioids may be effective but should not be used regularly due to risks. Clinical relevance: This research provides updated guidance on effective migraine treatments for clinicians.