A global comparison of clinical guidelines for the diagnosis and management of migraine: similarities, differences, and gaps.

This research paper compares clinical guidelines from various countries for diagnosing and managing migraines. It looks at recommendations from 2012 to 2025 across American, British, Italian, Japanese, French, and International Headache Society sources. All guidelines agree on using the International Classification of Headache Disorders (ICHD-3) for diagnosis. They recommend starting treatment early with analgesics and NSAIDs. Triptans are widely accepted for treating moderate-to-severe migraine attacks. Newer treatments like gepants and ditans are mentioned but are not available everywhere. For patients with frequent or severe migraines, preventive therapy is recommended. First-line preventive treatments include beta-blockers like propranolol, antiseizure medications like topiramate and valproate, and tricyclic antidepressants like amitriptyline. American and Japanese guidelines suggest using CGRP monoclonal antibodies and gepants as first-line treatments, highlighting evolving options for migraine management. Clinical relevance: This research underscores the need for consistent migraine treatment guidelines globally, which can improve patient care and access to effective therapies.