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Evidence-Based Guidelines for the Pharmacological Treatment of Migraine, Summary Version Publisher Pubmed



Ornello R1 ; Caponnetto V2 ; Ahmed F3 ; Alkhazali HM4 ; Ambrosini A5 ; Ashina S6, 7 ; Baraldi C8 ; Bellotti A9 ; Brighina F10 ; Calabresi P11, 12 ; Casillo F13 ; Cevoli S14 ; Cheng S15 ; Chiang CC16 Show All Authors
Authors
  1. Ornello R1
  2. Caponnetto V2
  3. Ahmed F3
  4. Alkhazali HM4
  5. Ambrosini A5
  6. Ashina S6, 7
  7. Baraldi C8
  8. Bellotti A9
  9. Brighina F10
  10. Calabresi P11, 12
  11. Casillo F13
  12. Cevoli S14
  13. Cheng S15
  14. Chiang CC16
  15. Chiarugi A17
  16. Christensen RH4, 7, 18, 19
  17. Chu MK20
  18. Coppola G13
  19. Corbelli I9
  20. Crema S21
  21. De Icco R22, 23
  22. De Tommaso M24
  23. Di Lorenzo C13
  24. Di Stefano V10
  25. Diener HC25
  26. Ekizoglu E26
  27. Fallacara A24
  28. Favoni V14
  29. Garces KN27
  30. Geppetti P28
  31. Goicochea MT21
  32. Granato A29
  33. Granella F30
  34. Guerzoni S8
  35. Ha WS31
  36. Hassan A32
  37. Hirata K33
  38. Hoffmann J34
  39. Hussler EM35
  40. Hussein M36
  41. Iannone LF16
  42. Jenkins B37
  43. Labastidaramirez A34
  44. Laporta A24
  45. Levin M38
  46. Lupica A10
  47. Mampreso E39
  48. Martinelli D22
  49. Monteith TS27
  50. Orologio I40
  51. Ozge A41
  52. Pan LLH42
  53. Panneerchelvam LL3
  54. Peres MFP43
  55. Souza MNP44
  56. Pozorosich P45, 46
  57. Prudenzano MP47
  58. Quattrocchi S14
  59. Rainero I48
  60. Romanenko V49
  61. Romozzi M11, 12
  62. Russo A40
  63. Sances G22
  64. Sarchielli P9
  65. Schwedt TJ50
  66. Silvestro M40
  67. Swerts DB43
  68. Tassorelli C22, 23
  69. Tessitore A40
  70. Togha M51, 52
  71. Vaghi G22, 23
  72. Wang SJ53, 54
  73. Ashina M4, 18
  74. Sacco S1
Show Affiliations
Authors Affiliations
  1. 1. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
  2. 2. Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
  3. 3. Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
  4. 4. Department of Neurology, Danish Headache Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
  5. 5. Headache Clinic - IRCCS NEUROMED, Pozzilli, Italy
  6. 6. Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, United States
  7. 7. Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
  8. 8. Digital and Predictive Medicine, Pharmacology and Clinical Metabolic Toxicology -Headache Center and Drug Abuse - Laboratory of Clinical Pharmacology and Pharmacogenomics, University of Modena, Modena, Italy
  9. 9. Department of Medicine and Surgery, University of Perugia, Perugia, Italy
  10. 10. Department of Biomedicine, Neuroscience and advanced Diagnostics (BIND), University of Palermo, Palermo, Italy
  11. 11. Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  12. 12. Dipartimento di Neuroscienze, Universita Cattolica del Sacro Cuore, Rome, Italy
  13. 13. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
  14. 14. IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Cefalee ed Algie Facciali, Bologna, Italy
  15. 15. Deparment of Neurology, Alfred Health, Melbourne, VIC, Australia
  16. 16. Department of Neurology, Mayo Clinic, Rochester, MN, United States
  17. 17. Department of Health Sciences, Section of Clinical Pharmacology and Oncology, Headache Center University Hospital, University of Florence, Florence, Italy
  18. 18. Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, United States
  19. 19. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
  20. 20. Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  21. 21. Neurology Department, Headache Clinic, Fleni, Buenos Aires, Argentina
  22. 22. Headache Science and Neurorehabilitation Unit, IRCSS Mondino Foundation, Pavia, Italy
  23. 23. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
  24. 24. DiBrain Department, Neurophysiopathology Unit, Bari Aldo Moro University, Bari, Italy
  25. 25. Department of Neuroepidemiology, Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Faculty of Medicine, University Duisburg-Essen, Essen, Germany
  26. 26. Department of Neurology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
  27. 27. Department of Neurology-Headache Division, University of Miami, Miller School of Medicine, Miami, FL, United States
  28. 28. Department of Molecular Pathobiology and Pain Research Center, College of Dentistry, New York University, NY, United States
  29. 29. Clinical Unit of Neurology, Headache Center, Department of Medical, Surgical and Health Sciences, University Hospital and Health Services of Trieste, ASUGI, University of Trieste, Trieste, Italy
  30. 30. Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, Parma, Italy
  31. 31. Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
  32. 32. Department of Neurology, Kasr Al Ainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt
  33. 33. Department of Neurology, Dokkyo Medical University, Mibu, Japan
  34. 34. Wolfson Sensory, Pain and Regeneration Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
  35. 35. Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
  36. 36. Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
  37. 37. Northern Headache and Neurology Centre, Royal North Shore Hospital, Sydney, Australia
  38. 38. UCSF Health, University of California, San Francisco, CA, United States
  39. 39. Headache Centre, Neurology - Euganea, Health Unit, Padua, Italy
  40. 40. Headache Centre of Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
  41. 41. Department of Neurology, Mersin University, Mersin, Turkey
  42. 42. Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
  43. 43. University of Sao Paulo, Paulo, Sao, Brazil
  44. 44. Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil
  45. 45. Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
  46. 46. Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
  47. 47. Headache Center, Amaducci Neurological Clinic, Polyclinic Hospital-University Consortium, Bari, Italy
  48. 48. Headache Center, Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy
  49. 49. Ukrainian Medical Academy, Ukraine
  50. 50. Department of Neurology, Mayo Clinic, Phoenix, AZ, United States
  51. 51. Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  52. 52. Headache Department, Neurology Ward, Sina Hospital, Medical School, Tehran University of Medical Sciences, Tehran, Iran
  53. 53. Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
  54. 54. College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

Source: Cephalalgia Published:2025


Abstract

We here present evidence-based guidelines for the pharmacological treatment of migraine. These guidelines, created by the Italian Society for the Study of Headache and the International Headache Society, aim to offer clear, actionable recommendations to healthcare professionals. They incorporate evidence-based recommendations from randomized controlled trials and expert-based opinions. The guidelines follow the GRADE approach for assessing the quality of evidence. The guideline development involved a systematic review of literature across multiple databases, adherence to Cochrane review methods, and a structured framework for data extraction and interpretation. Although the guidelines provide a robust foundation for migraine treatment, they also highlight gaps in current research, such as the paucity of head-to-head drug comparisons and the need for long-term outcome studies. These guidelines serve as a resource to standardize migraine treatment and promote high-quality care across different healthcare settings. © International Headache Society 2025.
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