Management of Migraine Using Pain Killers: A Systematic Review

Abstract

Introduction: Migraine is a disabling disease that can significantly impact work or school productivity and lead to absenteeism. The overuse of analgesics and anti-migraine drugs have been published in recent years. This review aimed to identify the advancement in management of migraine using various types of pian killers.
Methods: A systematic search was conducted of English-language articles in PubMed, Cochrane, and EMBASE databases to identify studies on the prevalence and incidence of chronic migraines. The search included terms related to chronic migraines, as well as epidemiological terms such as burden, prevalence, and incidence, and terms related to other types of chronic headache. Studies were included if they were population-based, conducted in adults, and reported prevalence and/or incidence estimates for CM or provided sufficient information to calculate these estimates.
Results: A total of 21 studies were included in a review of treatments for migraines. These studies included 11 randomized controlled trials, 5 retrospective reviews, and 4 prospective chart review studies. The studies evaluated a variety of treatments, including intravenous fluids, analgesics, dopamine receptor antagonists, valproic acid, propofol, magnesium, bupivicaine, triptan medications, and dihydroergotamine. The primary outcome in most of the studies was the change in pain on a visual analog scale at 30 minutes. One study found that ibuprofen had nearly three times the odds of efficacy compared to placebo at 2 hours, and was twice as effective as acetaminophen. Another study found that acetaminophen was superior to placebo in reducing headache intensity.
Conclusions: The use of recommended first-line therapies varied greatly within the healthcare system and the frequent use of narcotics was concerning due to the limited effectiveness of these drugs in the treatment of migraines and the increased risk of adverse side effects and drug abuse.