What are the updated AHS guidelines on the prevention and acute treatment of migraine headache?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
  • Print
Answer

An updated position statement from AHS in 2019 offers guidance on preventive and acute treatment of migraine. [154, 155] Recommendations include:

Preventive migraine treatment

  • Use evidence-based treatment
  • Start patient on a low dose and then titrate slowly
  • Reach a therapeutic dose, if possible
  • Treat for enough time to adequately judge treatment effectiveness
  • Establish realistic expectations about response and adverse events
  • Manage patient expectations and provide education to maximize treatment adherence

Acute migraine treatment

  • Use evidence-based treatment when possible
  • Treat early at the first sign of a migraine attack
  • Use a nonoral option for select patients, including those with nausea or vomiting or those who have trouble swallowing
  • Monitor safety and tolerability
  • Consider self-administered rescue treatments
  • Avoid overuse of acute medications

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!