Migraine Treatment and Prevention Strategies

Acute Treatment

The American Academy of Family Physicians and the Department of Veterans Affairs/Department of Defense recommend using NSAIDs (ibuprofen 400-800mg, naproxen 275-550mg, or aspirin 650-1000mg) or the combination of aspirin-acetaminophen-caffeine for acute treatment of mild-to-moderate migraine 1, 2
The Department of Veterans Affairs/Department of Defense strongly recommends triptans (sumatriptan, rizatriptan, eletriptan, or zolmitriptan) for moderate-to-severe migraine, with the combination of sumatriptan plus naproxen showing enhanced efficacy 2

The American College of Physicians and the Department of Veterans Affairs/Department of Defense recommend considering candesartan, telmisartan, or CGRP antagonists (erenumab, fremanezumab, galcanezumab) for prevention if headaches occur >2 times per week 2

The American Academy of Family Physicians requires specific diagnostic criteria to distinguish migraine from tension-type headache, including unilateral location, pulsating quality, moderate-to-severe intensity, and aggravation by routine physical activity 1

The American College of Physicians notes that GLP-1 receptor agonists, such as semaglutide, have headache listed as a common adverse effect in their prescribing information, occurring in approximately 6-14% of patients 2