A Narrative Review of Evidence-Based Preventive Options for Chronic Migraine

Curr Pain Headache Rep. 2015 Oct;19(10):49. doi: 10.1007/s11916-015-0521-0.

Abstract

Chronic migraine is a debilitating disorder that affects 2 % of the global population and imparts a significant societal and economic impact. The cornerstones of chronic migraine management include making an accurate diagnosis, patient education, treatment of comorbid conditions, and selection of an appropriate, evidence-based acute and preventive treatment regimen. Although it is common to treat chronic migraine with preventive medications effective for episodic migraine, a number of treatment options exist with specific evidence for effectiveness in chronic migraine. Currently, onabotulinumtoxinA injections are the only FDA-approved preventive treatment for chronic migraine. A number of non-medication treatment options including occipital nerve and supraorbital nerve stimulation have shown promise as effective prevention for patients either unable to tolerate or unable to obtain relief from oral medications, but more research is necessary.

Publication types

  • Review

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage*
  • Botulinum Toxins, Type A / administration & dosage*
  • Chronic Pain / drug therapy
  • Chronic Pain / prevention & control*
  • Evidence-Based Medicine
  • Humans
  • Migraine Disorders / drug therapy
  • Migraine Disorders / prevention & control*
  • Randomized Controlled Trials as Topic
  • Serotonin Agents / administration & dosage*

Substances

  • Acetylcholine Release Inhibitors
  • Serotonin Agents
  • Botulinum Toxins, Type A