The acute and prophylactic medical treatment of migraine and tension-type headache are different |
Treatment of acute attack of tension-type headache (paracetamol and/or NSAID) |
Treatment of acute migraine attack (paracetamol, and/or NSAID combined with domperidone; alternatively sumatriptan nasal spray) |
Avoid overuse of analgesics |
Prophylactic treatment is considered in very frequent or severely incapacitating headache, where the effect of non-pharmacological treatment has proven insufficient and where acute attack treatment is insufficient |
Generally, scientific evidence to underpin the effectiveness of prophylactic medical treatment in children with migraine and tension-type headache is very limited |
Prophylactic pharmacological treatment should be given in adequate doses for a minimum of 3 months before any decisions can be made with regard to its effect |
Treatment discontinuation should be attempted after 6–12 months to ensure that daily medication is still necessary |