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Migraine Treatment Guidelines Issued

Migraine headaches can be successfully treated and in many cases prevented, say new joint clinical guidelines from the US' 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, i.e. triptans and DHE nasal spray for more severe headaches. The guidelines are published in the current issue of Annals of Internal Medicine.

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.

The guidelines point out that the most successful treatment results from the patient's active involvement in charting the migraines and identifying and avoiding headache triggers. Commonly reported triggers include alcohol, chocolate, caffeine, red wine, foods containing additives (such as monosodium glutamate, tyramine or nitrates), sleep loss, stress, skipped meals, weather changes, perfumes or fumes.

The guidelines can be accessed online at:; Source: American College of Physicians-American Society of Internal Medicine


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