Canadian Headache Society Guideline: acute drug therapy for migraine headache.

Objectives: The primary objective of this guideline is to assist the practitioner in choosing an appropriate acute medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. It is focused on patients with episodic migraine ( headache on ≤ 14 days a month).

Methods: A detailed search strategy was used to find a relevant meta-analyses, systematic reviews and randomized double-blind controlled trials.

Canadian Headache Society guideline for migraine prophylaxis.

Objectives: The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month).

Methods: Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified.

Intranasal zolmitriptan.

Intranasal zolmitriptan has recently been launched in the US and Canada and is a novel formulation of the antimigraine drug zolmitriptan. This drug has been used extensively in its oral formulation. The intranasal formulation offers a more rapid onset of action.

A systematic review of the use of triptans in acute migraine.

Objective: A systematic review of the literature was undertaken, to consolidate evidence concerning the efficacy and safety of triptans currently available in Canada (sumatriptan, rizatriptan, naratriptan, zolmitriptan), and to provide guidelines for selection of a triptan.

Methods: Data from published, randomized, placebo-controlled trials were pooled and a combined number needed to treat (NNT) and number needed to harm (NNH) was generated for each triptan. Direct comparative trials of triptans were also examined.

Delivery systems for acute migraine medications.

Objective: To discuss advantages and disadvantages of various routes of administration and delivery systems for acute migraine medications, and to assist family physicians in optimizing treatment for individual patients.

Quality Of Evidence: A MEDLINE search from January 1966 to October 2000 and a Current Contents search for the year 1999 to October 2000 were conducted. Randomized controlled trials were selected, when available.