What are effective medical treatments for adults with acute migraine?
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Medications collectively referred to as “triptans” (eg, sumatriptan, naratriptan, etc) have been shown to be effective for acute migraine (strength of recommendation [SOR]: A). Nonsteroidal anti-inflammatory drugs (NSAIDs)—including aspirin, ibuprofen, naproxen sodium, diclofenac potassium, ketoprofen, tolfenamic acid, and ketorolac— are also effective (SOR: A). The combination of acetaminophen/aspirin/ caffeine is effective (SOR: B). Parenteral dihydroergotamine (DHE), when administered with an antiemetic, is as effective as, or more effective than meperidine, valproate, or ketorolac (SOR: B). Prochlorperazine is more effective than metoclopramide in headache pain reduction (SOR: A). Isometheptene mucate/dichloralphenazone/ acetaminophen is as effective as low-dose oral sumatriptan (SOR: B).
Journal of Family Practice, 55(6) 2006: 530-532.