title: Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.
abstract: OBJECTIVE
  To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: Are nonsteroidal anti-inflammatory drugs (NSAIDs) or other complementary treatments effective for migraine prevention?
  
  
  METHODS
  The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications for migraine prevention.
  
  
  RESULTS
  The author panel reviewed 284 abstracts, which ultimately yielded 49 Class I or Class II articles on migraine prevention; of these 49, 15 were classified as involving nontraditional therapies, NSAIDs, and other complementary therapies that are reviewed herein.
  
  
  CONCLUSIONS
  Petasites (butterbur) is effective for migraine prevention and should be offered to patients with migraine to reduce the frequency and severity of migraine attacks (Level A). Fenoprofen, ibuprofen, ketoprofen, naproxen, naproxen sodium, MIG-99 (feverfew), magnesium, riboflavin, and subcutaneous histamine are probably effective for migraine prevention (Level B). Treatments considered possibly effective are cyproheptadine, Co-Q10, estrogen, mefenamic acid, and flurbiprofen (Level C). Data are conflicting or inadequate to support or refute use of aspirin, indomethacin, omega-3, or hyperbaric oxygen for migraine prevention. Montelukast is established as probably ineffective for migraine prevention (Level B).
authors.affiliation: Armstrong Atlantic State University, Savannah, GA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Holland
authors.forename: S D
authors.initials: SD
authors.lastname: Silberstein
authors.forename: F
authors.initials: F
authors.lastname: Freitag
authors.forename: D W
authors.initials: DW
authors.lastname: Dodick
authors.forename: C
authors.initials: C
authors.lastname: Argoff
authors.forename: E
authors.initials: E
authors.lastname: Ashman
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000529:Complementary Therapies; D004958:Estradiol / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control*; D008903:Minerals / Q000627:therapeutic use; D016017:Odds Ratio; D008517:Phytotherapy; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008903:Minerals; D014815:Vitamins; D004958:Estradiol