How are migraines treated?
Pro Research Analysisby 
Searched over 200M research papers
Comprehensive Overview of Migraine Treatment Options
Pharmacological Treatments for Acute Migraine
Pharmacological therapy is a cornerstone in the acute treatment of migraine attacks. The American Headache Society has identified several effective medications, including triptans (e.g., sumatriptan, rizatriptan) and dihydroergotamine, which have strong evidence supporting their efficacy5. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, and naproxen, as well as acetaminophen, are also commonly used and effective6. Combination therapies, such as sumatriptan/naproxen and acetaminophen/aspirin/caffeine, provide additional options for patients5 6. However, opioids, while effective, are not recommended for regular use due to the risk of dependency and other side effects5 6.
Preventive Pharmacological Treatments
For patients experiencing frequent or severe migraine attacks, preventive medications are often prescribed. These include beta-blockers (e.g., metoprolol), anticonvulsants (e.g., topiramate), and other medications like sodium valproate10. These drugs aim to reduce the frequency and severity of migraine attacks but can have side effects that may limit their use10.
Non-Pharmacological Treatments
Manual Therapies and Physical Activity
Non-pharmacological treatments are increasingly being considered, especially for patients who cannot tolerate medications. Manual therapies, including massage therapy, physiotherapy, and chiropractic spinal manipulative therapy, have shown potential benefits comparable to some pharmacological treatments, although more rigorous studies are needed to confirm these findings4. Supervised physical activity has also been suggested to improve the quality of life for migraine sufferers1.
Acupuncture
Acupuncture is another non-pharmacological option that has been studied for its effectiveness in reducing the frequency and intensity of migraine attacks. While some studies suggest positive outcomes, the overall evidence remains mixed, and further research is needed to establish its efficacy definitively1 10.
Psychological Treatments and Patient Education
Psychological treatments, including cognitive-behavioral therapy (CBT), have been explored for their potential to manage migraine symptoms. Although the evidence is not robust, these treatments may offer benefits in conjunction with other therapies1. Patient education is also crucial, as it can improve self-rated health and quality of life by making patients more informed about their condition and treatment options1 2.
Role of Primary Care and Nursing Interventions
Primary care settings play a vital role in the management of migraine. Studies have shown that care administered by primary care nurses, supervised by general practitioners, can lead to fewer referrals to neurologists and more migraine-free days per month3. This approach highlights the importance of integrated care models in improving patient outcomes.
Emerging Treatments and Future Directions
Recent advancements in understanding migraine pathogenesis have led to the development of novel mechanism-based treatments. These emerging therapies aim to address unmet needs in migraine management and offer hope for more effective and tailored treatment options in the future7.
Conclusion
Migraine treatment is multifaceted, involving both pharmacological and non-pharmacological strategies. Acute treatments primarily include triptans, NSAIDs, and combination therapies, while preventive treatments often involve beta-blockers and anticonvulsants. Non-pharmacological options such as manual therapies, acupuncture, and psychological treatments provide additional avenues for managing migraines. The role of primary care and nursing interventions is also crucial in optimizing treatment outcomes. As research continues to evolve, emerging treatments hold promise for more effective and personalized migraine management.
Sources and full results
Most relevant research papers on this topic
Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education in migraine treatment. A systematic review and meta-analysis
Weak recommendations for considering manual joint mobilization, supervised physical activity, acupuncture, and patient education as a supplement to standard migraine treatment.
Meta-Analysis
Rigorous JournalDiagnosis and management of migraine in ten steps
This ten-step approach to migraine diagnosis and management emphasizes patient centricity, education, and best practices for acute and preventive treatment in various patient populations, supporting clinical decision-making by general practitioners, neurologists, and headache specialists.
Highly CitedNurses improve migraine management in primary care
Nurse-supervised migraine management in primary care led to fewer referrals to neurologists and more migraine-free days per month, but no change in HIT score or patient satisfaction.
RCTRigorous JournalManual therapies for migraine: a systematic review
Massage therapy, physiotherapy, relaxation, and chiropractic spinal manipulative therapy may be equally effective as propranolol and topiramate in migraine prophylactic management, but future well-conducted randomized clinical trials are needed for confirmation.
Systematic ReviewRigorous JournalHighly CitedThe Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies
Many acute migraine treatments have evidence supporting their efficacy, including triptans, dihydroergotamine, and various nonspecific medications.
Systematic ReviewRigorous JournalHighly CitedAcute Migraine Treatment in Adults
Acetaminophen, NSAIDs, and triptans are effective acute migraine treatments, but individualized treatment plans are needed based on patient features and contraindications.
Literature ReviewRigorous JournalHighly CitedMigraine: integrated approaches to clinical management and emerging treatments
Current migraine treatment options include pharmacological therapies, non-pharmacological therapies, and emerging treatments, with a multidisciplinary approach to effective clinical management.
Rigorous JournalHighly CitedMigraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action
Acute migraine medications aim to rapidly restore function with minimal recurrence and avoid side effects, with individualized treatment choices based on attack characteristics, patient preferences, and drug properties.
Very Rigorous JournalHighly CitedAcupuncture for the prevention of episodic migraine
Acupuncture may be a low-risk, effective alternative for episodic migraine prevention, with potential benefits similar to analgesia.
Highly CitedTry another search
How much Gymnema sylvestre should I take daily?
What is the impact of online social networks on community building and social support?
The potential of ocean thermal energy conversion in renewable energy generation.
Limit order book fill probability
what are the most evidenced based interventions for reducing recidivism
What are the applications of stem cell research in medicine?