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The ACP has issued a clinical guideline addressing outpatient drug treatment of patients with acute episodic migraine headache. The authors note that their evidence review relied mostly on randomized comparisons between active drug and placebo; head-to-head comparisons between drugs approved for migraine treatment comprised only a small minority of trials.
The guideline makes only two formal recommendations, addressing treatment of moderate-to-severe acute migraine in nonpregnant adults in outpatient settings:
For patients who do not respond adequately to nonsteroidal anti-inflammatory drugs (NSAIDs), clinicians should add a triptan (strong recommendation; m…