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Preventive treatment in migraine and the new US guidelines

Authors Estemalik E, Tepper S

Received 11 December 2012

Accepted for publication 18 March 2013

Published 17 May 2013 Volume 2013:9 Pages 709—720

DOI https://doi.org/10.2147/NDT.S33769

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

E Estemalik, S Tepper

Cleveland Clinic, Neurological Center for Pain, Cleveland, Ohio, USA

Abstract: Migraine headaches are among the most common headache disorders seen in various practices. The prevalence of migraine headaches is 18% in women and 6% in men. While millions of Americans suffer from migraine headaches, roughly 3%–13% of identified migraine patients are on preventive therapy, while an estimated 38% actually need a preventive agent. The challenge among physicians is not only when to start a daily preventive agent but which preventive agent to choose. Circumstances warranting prevention have been described in the past, and in 2012, a new set of guidelines with an evidence review on preventive medications was published. A second set of guidelines provided evidence on nonsteroidal anti-inflammatory drugs, herbs, minerals, and vitamins for prevention of episodic migraine. This article describes the updated US guidelines for the prevention of migraines and also outlines the major studies from which these guidelines were derived.

Keywords: US guidelines, Canadian guidelines, classification, preventive medication

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