Nation's two largest medical specialty groups issue migraine treatment guidelines

PHILADELPHIA -- (November 19, 2002) Migraine headaches can be successfully treated and in many cases prevented, say new joint clinical guidelines from the nation's two largest groups of primary care physicians. The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) and the American Academy of Family Physicians (AAFP) say the first line of treatment for migraines are non-steroidal, anti-inflammatory drugs (NSAIDs), followed by prescription drugs called triptans and DHE nasal spray for more severe headaches. The guidelines are published in the Nov. 19, 2002, issue of Annals of Internal Medicine.

Migraines are severe recurring headaches that can disable sufferers for hours up to several days. In addition to throbbing head pain, symptoms can include nausea, vomiting, and sensitivity to light, noise and odors.

The first line NSAIDs proven to work are the familiar, inexpensive, over-the-counter, medications aspirin and ibuprofen as well as naproxen sodium and a combination of acetaminophen plus aspirin and caffeine. Acetaminophen alone has been proven not to work for migraines.

If NSAIDs don't work, physicians should prescribe drugs called triptans. The guidelines advise treating migraines immediately and also treating the nausea and vomiting that accompany some migraines with specific remedies for these symptoms. The recommended medications were deemed effective in at least two double-blind, placebo-controlled trials.

"Migraine patients should know that migraines can and should be treated at once," said Kevin B. Weiss, MD, chairman of the ACP-ASIM Clinical Efficacy Assessment Subcommittee that helped develop the guidelines. "We physicians don't want patients suffering longer than needed. We want to help them get on their feet and functioning."

"Another goal is to reduce use of back-up and rescue medications," Weiss said. "Patients should know that more isn't necessarily better when treating migraines. A

Contact: Susan Anderson
American College of Physicians

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