Review finds little difference between effectiveness of drugs routinely prescribed for migraine prevention but evident difference in the side-effects experienced
Migraine headaches are a major cause of ill health and a reduced quality of life. Some individuals suffer from a frequent and severe migraine problem which means that they require regular medication to try and prevent them. A new review- of the medications, which may help to prevent episodic migraines, appears in the Journal of General Internal Medicine-, published by Springer. The authors, Tatyana Shamliyan from the University of Minnesota School of Public Health, and her colleagues, compare published research on the drugs available to find those which offer the best migraine prevention coupled with the fewest adverse side-effects.
Preventive treatments for migraines aim to reduce the number of migraines suffered by fifty percent. There are a number of different drugs commonly used, all of which may cause some side effects. The researchers carried out a review of studies which tested how well the different types of drugs worked and also their acceptability in terms of adverse effects suffered. The studies used enrolled mostly middle aged women with episodic migraine who suffered an average of five monthly migraine attacks.
The authors found that all approved drugs used in the reviewed trials worked better than placebo in reducing monthly migraine attacks. They all demonstrated similar effects in that they prevented half or more migraines in 200 to 400 patients per 1000 treated. Off-label anti-epilpetics and anti-depressants appeared to cause the most bothersome side effects which usually resulted in the medication being stopped. Off-label beta-blockers and angiotensin-inhibiting drugs caused the fewest side-effects. (Off-label drugs are drugs which have not been approved by the Food and Drug Administration for a specific condition).