The abortive (symptomatic) therapy of migraine ranges from the use of simple analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to triptans, antiemetics, calcitonin gene-related peptide (CGRP) antagonists, lasmiditan, and dihydroergotamine. Gabapentin is used "off-label" for migraine prevention and treatment, including migraines with or without aura, vestibular migraines. It reduces the frequency of headaches, pain intensity, and the use of symptomatic medications 1, 2. However, gabapentin is not helpful for migraine aura, vertigo, or other accompaing symptoms. Objective While there are several trials that support the efficacy of various drugs for migraine prophylaxis against placebo, there is limited evidence addressing the comparative safety and efficacy of these drugs. We conducted a systematic review and network meta-analysis to facilitate comparison between drugs for migraine prophylaxis. Methods We searched MEDLINE, EMBASE, CENTRAL, and First-line medications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol. Medications such as amitriptyline, Off-label, gabapentin has been used in the treatment of migraine and other types of headache, including cluster and tension headaches. It shows potential as an option for those living with migraine and other headache disorders. Gabapentin does not decrease the frequency of migraine headaches and is not recommended for prophylactic therapy. (Strength of Recommendation: B, based on inconsistent or The 2021 American Headache Society consensus guideline recommends that preventive pharmacologic therapy should be considered for patients with 4 or more migraine headache days per month or those with 2 or more migraine headache days per month that are associated with substantial disability despite use of acute medication. 2 Preventive treatment American Migraine Foundation® is a recognized public charity under Internal Revenue Code section 501(c)(3) status. Donations to the American Migraine Foundation are tax-deductible to the extent permitted by law. The American Migraine Foundation EIN is 85-2527027. This gepant is a Preventive migraine medication. Available in Canada as of March 2023 · Nurtec (Rimegepant) — FDA approved February 2020 (oral dissolving tablet). This gepant is both an Acute and Preventive migraine medication but currently only approved for Acute use in Canada. Available in Canada as of April 2024. Many medications claim to relieve migraine pain, but some are more helpful than others. In a large study looking at real-world data on 25 drugs, migraine sufferers rated the most and least helpful options. According to the American Migraine Prevalence and Prevention (AMPP) Study, 38.8% of patients with migraine should be considered for (13.1%) or offered (25.7%) preventive migraine therapy.16 Unfortunately, the underutilization of migraine preventive medications is underscored by the fact that only 13% of all patients with migraine currently use Gabapentin shows to have an effective therapeutic action in the prophylactic treatment of migraine. Our observations indicate that gabapentin is well tolerated by patients and that reduces headache frequency and use of symptomatic drugs in both groups. Many drugs can effectively help migraine by treating active symptoms or preventing new episodes from occurring as often or severely. Medication options to help relieve a migraine include triptans, antiemetics, and ergots. Medications that can help prevent migraine include certain blood pressure medications, antiepileptics, and antidepressants. Alcohol can increase the nervous system side effects of gabapentin such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with gabapentin. "This medication, gabapentin, was a lifesaver for migraines. I had very bad headaches along with gum and tooth pain, and just after two days of taking this med, my pain is gone and I’m a new person. It has helped my anxiety tremendously, as well as my sleep. I am so thankful. Please don’t lose hope. Just try it, and it might work for you. Generally, gabapentin isn’t used as a primary therapy for migraine prevention, but as an additional treatment to support other therapies. The drugs used to prevent migraine attacks are Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness. Gabapentin may be used alone or with other medications when necessary. The American Academy of Neurology (AAN) and the American Headache Society (AHS) do not list gabapentin as "effective" or "probably effective" for preventing migraines in their 2012 guidelines. Studies were required to be prospective, controlled trials of gabapentin/gabapentin enacarbil or pregabalin taken regularly to prevent the occurrence of migraine attacks, to improve migraine‐related quality of life, or both. Two review authors independently selected studies and extracted data. Several medications prevent or reduce migraine headaches when taken regularly. Antihypertensives are inexpensive and effective. Gabapentin (Neurontin) is minimally effective at high doses, and
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