The Resource Drug treatments for the prevention of migraine headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University ; contributing authors, Rebecca N. Gray ... [et al.], (electronic resource)

Drug treatments for the prevention of migraine headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University ; contributing authors, Rebecca N. Gray ... [et al.], (electronic resource)

Label
Drug treatments for the prevention of migraine headache
Title
Drug treatments for the prevention of migraine headache
Statement of responsibility
prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University ; contributing authors, Rebecca N. Gray ... [et al.]
Contributor
Subject
Language
  • eng
  • eng
Summary
OBJECTIVES: To identify and summarize evidence from controlled trials on the efficacy and tolerability of drug treatments for the prevention of migraine. SEARCH STRATEGY: A strategy combining the MeSH term "headache" (exploded) and a previously published strategy for identifying randomized controlled trials were used on the January 1966 to December 1996 MEDLINE database. Other computerized bibliographic databases, textbooks, and experts were also utilized. SELECTION CRITERIA: We selected English-language controlled trials involving patients with migraine headache in which at least one treatment offered was a drug given regularly during headache-free intervals with the aim of preventing the occurrence of migraine attacks. DATA COLLECTION AND ANALYSIS: Measures of headache index and headache frequency reported as group means (and standard deviations) were used to calculate standardized mean differences (or effect sizes). The number of patients obtaining at least a 50% reduction in headache index, frequency, or severity was recorded and used to calculate odds ratios. Where similar trials provided data, meta-analysis of efficacy measures was performed. The identity and rates of adverse events were recorded and statistically compared. MAIN RESULTS: Placebo-controlled trials support the efficacy of several drugs for the prevention of migraine. Drugs with multiple placebo-controlled trials suggesting at least moderate efficacy include: propranolol (effect size, 0.55; 95% confidence interval, 0.42 to 0.69), timolol (0.69; 0.18 to 1.2), sodium valproate and divalproex sodium (0.93; 0.39 to 1.5), naproxen sodium (0.29; 0.01 to 0.57), amitriptyline (0.62; 0.15 to 1.1), methysergide (no effect size estimate), flunarizine (0.52; 0.24 to 0.80), pizotifen (0.91; 0.50 to 1.3), and lisuride (no effect size estimate). Other beta-blockers demonstrated efficacy similar to that of propranolol, except for those with intrinsic sympathomimetic activity, which did not appear to be efficacious. Within other, more diverse drug categories -- such as antidepressants, calcium antagonists, and anticonvulsants -- there was more variability in the efficacy of different agents. Except for the comparison of propranolol with flunarizine, equivalence has not been demonstrated among the various agents found to be efficacious in placebo-controlled trials. Many efficacious preventive drugs were poorly tolerated in the reviewed trials and were associated with substantial rates of patient withdrawals. CONCLUSIONS: Several specific agents have been shown to be efficacious for the prevention of migraine; however, there are few data to guide the choice among agents, and poor tolerability and lack of availability in the U.S. limit the usefulness of many of the drugs reviewed
Member of
Additional physical form
Also issued in print.
Cataloging source
DNLM
Funding information
"Contract No. 290-94-2025."
Government publication
federal national government publication
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WL 344
http://library.link/vocab/relatedWorkOrContributorName
  • Gray, Rebecca N
  • United States
  • Duke University
Series statement
Technical review
Series volume
2.3
http://library.link/vocab/subjectName
  • Migraine Disorders
  • Migraine Disorders
  • Treatment Outcome
  • Controlled Clinical Trials as Topic
  • Evidence-Based Medicine
  • Meta-Analysis as Topic
Label
Drug treatments for the prevention of migraine headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University ; contributing authors, Rebecca N. Gray ... [et al.], (electronic resource)
Instantiates
Publication
Note
  • Title from PDF t.p
  • "February 1999."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Extent
1 online resource (1 PDF file (v, 421 p.))
Form of item
online
Specific material designation
remote
System control number
  • 1554787
  • (DNLM)BKSHLF:NBK45457
System details
Mode of access: Internet
Label
Drug treatments for the prevention of migraine headache, prepared for Agency for Health Care Policy and Research, Department of Health and Human Services, U.S. Public Health Service ; prepared by Center for Clinical Health Policy Research, Duke University ; contributing authors, Rebecca N. Gray ... [et al.], (electronic resource)
Publication
Note
  • Title from PDF t.p
  • "February 1999."
Bibliography note
Includes bibliographical references
Dimensions
unknown
Extent
1 online resource (1 PDF file (v, 421 p.))
Form of item
online
Specific material designation
remote
System control number
  • 1554787
  • (DNLM)BKSHLF:NBK45457
System details
Mode of access: Internet

Library Locations

  • African Studies LibraryBorrow it
    771 Commonwealth Avenue, 6th Floor, Boston, MA, 02215, US
    42.350723 -71.108227
  • Alumni Medical LibraryBorrow it
    72 East Concord Street, Boston, MA, 02118, US
    42.336388 -71.072393
  • Astronomy LibraryBorrow it
    725 Commonwealth Avenue, 6th Floor, Boston, MA, 02445, US
    42.350259 -71.105717
  • Fineman and Pappas Law LibrariesBorrow it
    765 Commonwealth Avenue, Boston, MA, 02215, US
    42.350979 -71.107023
  • Frederick S. Pardee Management LibraryBorrow it
    595 Commonwealth Avenue, Boston, MA, 02215, US
    42.349626 -71.099547
  • Howard Gotlieb Archival Research CenterBorrow it
    771 Commonwealth Avenue, 5th Floor, Boston, MA, 02215, US
    42.350723 -71.108227
  • Mugar Memorial LibraryBorrow it
    771 Commonwealth Avenue, Boston, MA, 02215, US
    42.350723 -71.108227
  • Music LibraryBorrow it
    771 Commonwealth Avenue, 2nd Floor, Boston, MA, 02215, US
    42.350723 -71.108227
  • Pikering Educational Resources LibraryBorrow it
    2 Silber Way, Boston, MA, 02215, US
    42.349804 -71.101425
  • School of Theology LibraryBorrow it
    745 Commonwealth Avenue, 2nd Floor, Boston, MA, 02215, US
    42.350494 -71.107235
  • Science & Engineering LibraryBorrow it
    38 Cummington Mall, Boston, MA, 02215, US
    42.348472 -71.102257
  • Stone Science LibraryBorrow it
    675 Commonwealth Avenue, Boston, MA, 02445, US
    42.350103 -71.103784
Processing Feedback ...