The American College of Physicians (ACP) has released new clinical guidelines for the pharmacologic treatment of acute episodic migraine headaches in outpatient settings. The recommendations, published in the Annals of Internal Medicine on March 18, aim to help physicians and clinicians manage migraine episodes more effectively in adults.

The guidelines are based on an extensive review led by Dr. Amir Qaseem and his team from ACP, who evaluated the comparative benefits and risks of available treatments, patient preferences, and economic considerations. The focus is on adults experiencing acute episodic migraines, defined as having between one and 14 headache days per month.

The ACP presented two key recommendations. First, for nonpregnant adults who do not achieve adequate relief from nonsteroidal anti-inflammatory drugs (NSAIDs), the guidelines strongly recommend adding a triptan to treat moderate-to-severe migraine headaches. This recommendation is backed by moderate-certainty evidence.

Second, for nonpregnant adults whose migraines are not sufficiently relieved by acetaminophen, clinicians are advised to consider adding a triptan as well, though this is a conditional recommendation supported by low-certainty evidence.

“There is a critical need for funding agencies, such as the Patient-Centered Outcomes Research Institute or the National Institute of Neurological Disorders and Stroke, to support well-designed comparative trials of newer migraine medications,” the authors emphasized. They highlighted the importance of comparing newer treatments with the combination of triptans and NSAIDs or acetaminophen to determine the most effective options for patients.

These updated guidelines come as millions of migraine sufferers continue to seek more effective treatments for managing sudden and severe headache episodes.