EFNS guideline on the drug treatment of migraine - Revised report of an EFNS task force

S. Evers, J. Áfra, A. Frese, P. J. Goadsby, M. Linde, A. May, P. S. Sándor

Research output: Article

399 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)968-981
Number of pages14
JournalEuropean Journal of Neurology
Volume16
Issue number9
DOIs
Publication statusPublished - szept. 2009

Fingerprint

Advisory Committees
Migraine Disorders
Guidelines
Pharmaceutical Preparations
Tryptamines
Therapeutics
Petasites
Anti-Inflammatory Agents
Bisoprolol
Dihydroergotamine
Flunarizine
Domperidone
Migraine without Aura
Sumatriptan
Migraine with Aura
Naproxen
Metoclopramide
Amitriptyline
Metoprolol
Valproic Acid

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

EFNS guideline on the drug treatment of migraine - Revised report of an EFNS task force. / Evers, S.; Áfra, J.; Frese, A.; Goadsby, P. J.; Linde, M.; May, A.; Sándor, P. S.

In: European Journal of Neurology, Vol. 16, No. 9, 09.2009, p. 968-981.

Research output: Article

Evers, S. ; Áfra, J. ; Frese, A. ; Goadsby, P. J. ; Linde, M. ; May, A. ; Sándor, P. S. / EFNS guideline on the drug treatment of migraine - Revised report of an EFNS task force. In: European Journal of Neurology. 2009 ; Vol. 16, No. 9. pp. 968-981.
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