Preventive therapies for migraine*
Group 1† | Group 2‡ | Group 3§ | Group 4¶ | Group 5∥ |
---|---|---|---|---|
* Does not include combination products. | ||||
† Medium to high efficacy, good strength of evidence, and mild-to-moderate side effects. | ||||
‡ Lower efficacy than those listed in first column, or limited strength of evidence, and mild-to-moderate side effects. | ||||
§ Clinically efficacious based on consensus and clinical experience, but no scientific evidence of efficacy. | ||||
¶ Medium to high efficacy, good strength of evidence, but with side effect concerns. | ||||
∥ Evidence indicating no efficacy over placebo. | ||||
Amitriptyline | B-blockers | A: Antidepressants | Methysergide | Acebutolol |
Divalproex sodium | Atenolol/metoprolol/nadolol | Doxepine | Carbamazepine | |
Propranolol/timolol | Fluvoxamine | Clomipramine, clonazepam | ||
Ca-blockers | Imipramine | Clonidine | ||
Nimodipine/verapamil | Mirtazepine | Indomethacin | ||
Nortriptyline | Nicardipine | |||
NSAIDs | Paroxetine | Nifedipine | ||
Aspirin/fenoprofen/flurbiprofen | Protriptyline | Pindolol | ||
Ketoprofen | Sertraline trazodone | |||
Mefenamic acid | Venlafaxine | |||
Neproxen | Cyproheptadine diltiazem | |||
Naproxen sodium | Ibuprofen | |||
Fluoxetine (racemic) | Tiagabine | |||
Gabapentine | Topiramate | |||
Other | B: (side effect concerns) | |||
Feverfew | Methylergonovine (methylergometrine) | |||
Magnesium vitamin B2 | Phenelzine |