Role of Steroids in Chronic Primary Headaches

Appropriate Uses for Steroids in Headache Management

• Steroids may be the treatment of choice for patients with status migrainosus, though there are no good studies documenting their efficacy in treating acute migraine attacks 1

Evidence for Specific Headache Types

• For chronic migraine: Steroids are not listed among the recommended prophylactic medications in current guidelines, according to the American Academy of Neurology 2, 3, 4

Limitations and Precautions

• First-line treatments for chronic primary headaches should include: For prophylaxis: Topiramate, valproate, beta-blockers, and onabotulinumtoxinA (for chronic migraine), as recommended by the American Academy of Neurology 2, 3, 4
• For acute treatment: NSAIDs, triptans, and combination analgesics, as recommended by the American Academy of Family Physicians 1