Dexamethasone in Migraine Treatment

Standard Migraine Treatment Approach

• The American College of Neurology recommends NSAIDs as first-line therapy for most patients with migraine headaches, including aspirin, ibuprofen, naproxen sodium, and diclofenac potassium 1
• Combination therapy of acetaminophen plus aspirin plus caffeine is effective, though acetaminophen alone is not recommended 2
• Treatment should begin as early as possible during an attack for maximum efficacy 2

Important Considerations and Cautions

• Routine use of dexamethasone for acute migraine is not supported by guidelines 1, 2, 3
• Medications to avoid in migraine treatment include oral ergot alkaloids, opioids, and barbiturates due to questionable efficacy, adverse effects, and risk of dependency 1
• Medication overuse headache is a risk when acute treatments are used too frequently (≥15 days per month with NSAIDs or ≥10 days per month with triptans) 2