Acute therapies for migraine
Group 1* | Group 2† | Group 3‡ | Group 4§ | Group 5¶ |
---|---|---|---|---|
* Proven, pronounced statistical and clinical benefit (at least two double-blind, placebo-controlled studies and clinical impression of effect). | ||||
† Moderate statistical and clinical benefit (one double-blind, placebo-controlled study and clinical impression of effect). | ||||
‡ Statistically but not proven clinically or clinically but not proven statistically effective (conflicting or in consistent evidence). | ||||
§ Proven to be statistically or clinically ineffective (failed efficacy versus placebo). | ||||
Clinical and statistical benefits uknown (insufficient evidence available). | ||||
Specific | Acetaminophen plus codeine PO | Butalbital, aspirin, plus caffeine PO | Acetaminophen PO | Dexamethaxone IV |
Naratriptan PO | Butalbital, aspirin, caffeine, plus codeine PO | Ergotamine PO | Chlorpromazine IM | Hydrocortisone IV |
Rizatriptan PO | Butorphanol IM | Ergotamine plus caffeine PO | Granisetron IV | |
Sumatriptan SC, IN, PO | Chlorpromazine IM, IV | Metocloproamide IM, PR | Lidocraine IV | |
Zolmitriptan PO | Diclofenac K, PO | |||
DHE SC, IM, IV, IN | Ergotamine plus caffeine plus pentobarbital plus Bellafoline® PO | |||
DHE IV, plus antiemetic | Flurbiprofen, PO | |||
Nonspecific | Isometheptene CPD, PO | |||
Acetaminophen, aspirin, plus caffeine PO | Ketorolac IM | |||
Aspirin PO | Lidocaine IN | |||
Butorphanol IN | Meperidine IM, IV | |||
Ibuprofen PO | Methadone IM | |||
Naproxen sodium PO | Metoclopramide IV | |||
Prochlorperazine IV | Naproxen PO | |||
Prochlorperazine IM, PR |