Migraine Treatment Guidelines

Standard Migraine Treatment

The American College of Physicians recommends NSAIDs as first-line therapy for most migraine sufferers, with evidence supporting aspirin, ibuprofen, naproxen sodium, and combination medications containing acetaminophen, aspirin, and caffeine 1, 3
Acetaminophen alone lacks evidence for migraine treatment 1
Migraine-specific agents, such as triptans and DHE, are recommended when NSAIDs fail 1, 3
Non-oral routes should be selected when nausea/vomiting are significant symptoms 1

The American Academy of Neurology recommends first-line preventive agents, including propranolol (80-240 mg/day), timolol (20-30 mg/day), amitriptyline (30-150 mg/day), divalproex sodium (500-1500 mg/day), and sodium valproate (800-1500 mg/day) 1

Medication overuse headache is a risk with frequent use of acute medications (>2 days/week) 1, 3