Authors' objectives: To assess comparative effectiveness and safety of preventive pharmacologic treatments for community-dwelling adults with episodic or chronic migraine.

Authors' recommendations: For chronic migraine, onabotulinumtoxin A reduced migraine attacks but increased the risk of adverse effects and treatment discontinuation due to adverse effects. For episodic migraine, approved drugs are effective but increase risk of adverse effects and treatment discontinuation due to adverse effects. Some off-label beta blockers and angiotensin inhibiting drugs are effective without bothersome harms and therefore offer the best benefits-to-harms ratio. We could not determine the long-term (i.e., trials of more than 3 months' duration), preventive benefits and adherence with drugs. Evidence on improving quality of life was inconsistent across individual drugs. Evidence for individualized treatment decisions is very limited. Future research should examine the role of patient characteristics on drug benefits and safety.

Project Status: Completed

Year Published: 2013

URL for published report: http://www.effectivehealthcare.ahrq.gov/ehc/products/313/1453/migraine-report-130408.pdf

URL for additional information: http://www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1520

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)