Clinical Inquiries. What are effective medical treatments for adults with acute migraine?

❚ Evidence summary The prevalence of migraine headache is 6% among men and 15% to 17% among women. However, no standardized approach exists for the treatment of acute migraine headache. Systematic reviews of randomized controlled trials (RCTs) summarized that oral sumatriptan (Imitrex), Medications collectively referred to as “triptans” (eg, sumatriptan, naratriptan, etc) have been shown to be effective for acute migraine (strength of recommendation [SOR]: A). Nonsteroidal anti-inflammatory drugs (NSAIDs)—including aspirin, ibuprofen, naproxen sodium, diclofenac potassium, ketoprofen, tolfenamic acid, and ketorolac—are also effective (SOR: A). The combination of acetaminophen/aspirin/ caffeine is effective (SOR: B). Parenteral dihydroergotamine (DHE), when administered with an antiemetic, is as effective as, or more effective than meperidine, valproate, or ketorolac (SOR: B). Prochlorperazine is more effective than metoclopramide in headache pain reduction (SOR: A). Isometheptene mucate/dichloralphenazone/acetaminophen is as effective as low-dose oral sumatriptan (SOR: B).