Table 2 Summary of drugs recommended for migraine prophylaxis, with level of evidence for each European country
From: A review of current European treatment guidelines for migraine
Country | UK (lines of recommendation) | Scotland (grades of recommendation) | Germany (strength of recommendation) | Croatia (rating of recommendation) | Spain (levels of evidence) | France (grading of recommendation) | Italy (levels of recommendation) |
|---|---|---|---|---|---|---|---|
β-blockers | |||||||
Metoprolol | 1 | D | A | B | 1 | A | 2 |
Propranol | 1 | A | A | A | 1 | A | 1 |
Atenolol | 1 | D | – | A | 1 | A | 1 |
Bisoprolol | 1a | – | B | – | – | – | – |
Nadolol | D | – | B | 1 | A | 2 | |
Timolol | D | – | – | – | A | – | |
Ca channel blockers | |||||||
Flunarizine | NA | A | A (NA) | 1 | A | 1 | |
Cinnarizine | – | – | – | – | 2 | ||
Verapamil | – | B | – | – | 2 | ||
Diltiazem | – | – | – | – | 3a | ||
Nimodipine | – | B | – | – | 3a | ||
Anti-epileptic drugs | |||||||
Valproic acid | 2 | A | A | A | 1 | A | 1 |
Topiramate | 2 | A | A | B | 1 | A | 2 |
Gabapentin | 3 | C | C | A | – | A | 2 |
Lamotrigine | – | – | – | B | – | – | 2 |
Tricyclic antidepressants | |||||||
Amitriptyline | 1 | B | B | A | 1 | A | 1 |
Nortryptiline | – | – | – | C | – | – | 3aa |
Doxepin | – | – | – | C | – | – | 4 |
Imipramine | – | – | – | C | – | – | – |
Others antidepressants | |||||||
Venlafaxine | – | B | – | – | 4 | ||
Fluoxetine | 4 | – | – | B | 2 | ||
Paroxetine | – | – | – | B | 3 | ||
Mirtazapine | – | – | – | – | 4 | ||
NSAIDs | |||||||
Aspirin | C | B | – | 3b | |||
Naproxen | B | B | A | 2 | |||
Ketoprofen | – | B | – | 4 | |||
Miscellaneous drugs | |||||||
Magnesium | C | ||||||
Butterburr | B | ||||||
Feverfew | NR | B | B | ||||
Botulinum toxin | – | 2 | |||||
Candesartan | – | ||||||
Serotonin antagonists | |||||||
Pizotifen | A (NA) | A | |||||
Methisergide | |||||||