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ACP Issues Clinical Guideline for Pharmacologic Treatment of Acute Episodic Migraine

Medically reviewed by Carmen Pope, BPharm. Last updated on March 21, 2025.

By Elana Gotkine HealthDay Reporter

FRIDAY, March 21, 2025 -- In a clinical guideline issued by the American College of Physicians (ACP) and published online March 18 in the Annals of Internal Medicine, recommendations are presented for the pharmacologic treatment of acute episodic migraine headache in the outpatient setting.

Amir Qaseem, M.D., Ph.D., from the ACP in Philadelphia, and colleagues examined the comparative benefits and harms of pharmacologic treatments of acute episodic migraine headache, patients' values and preferences, and economic evidence relating to the treatments. The guidelines were designed for physicians and other clinicians and related to adults with acute episodic migraine headache (defined as one to 14 headache days per month) managed in outpatient settings.

The authors presented two recommendations. For nonpregnant adults who do not respond adequately to a nonsteroidal anti-inflammatory drug, ACP recommends the addition of a triptan to treat moderate-to-severe acute episodic migraine headache in outpatient settings (strong recommendation; moderate-certainty evidence). For nonpregnant adults who do not respond adequately to acetaminophen, ACP suggests that clinicians add a triptan to treat moderate-to-severe acute episodic migraine headache in outpatient settings (conditional recommendation; low-certainty evidence).

"There is a critical need for funding agencies, such as the Patient-Centered Outcomes Research Institute or National Institute of Neurological Disorders and Stroke, to support well-designed, comparative effectiveness trials of newer medications to treat moderate-to-severe episodic migraine compared with the combination of a triptan and an NSAID or acetaminophen," the authors write.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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Posted March 2025

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