Consensus of the Brazilian Headache Society on the treatment of chronic migraine

• Autor(a) principal: KOWACS,Fernando
• Data de Publicação: 2019
• Outros Autores: ROESLER,Célia Aparecida de Paula, PIOVESAN,Élcio Juliato, SARMENTO,Elder Machado, CAMPOS,Henrique Carneiro de, MACIEL JR,Jayme Antunes, CALIA,Leandro Cortoni, BAREA,Liselotte Menke, CICIARELLI,Marcelo Cedrinho, VALENÇA,Marcelo Moraes, COSTA,Maria Eduarda Nobre de Magalhães, PERES,Mário Fernando Prieto, KOWACS,Pedro André, ROCHA-FILHO,Pedro Augusto Sampaio, SILVA-NÉTO,Raimundo Pereira da, VILLA,Thais Rodrigues, JURNO,Mauro Eduardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Arquivos de neuro-psiquiatria (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2019000700509
• topic: Migraine disorders; headache; headache disorders

ABSTRACT Chronic migraine poses a significant personal, social and economic burden and is characterized by headache present on 15 or more days per month for at least three months, with at least eight days of migrainous headache per month. It is frequently associated with analgesic or acute migraine medication overuse and this should not be overlooked. The present consensus was elaborated upon by a group of members of the Brazilian Headache Society in order to describe current evidence and to provide recommendations related to chronic migraine pharmacological and nonpharmacological treatment. Withdrawal strategies in medication overuse headache are also described, as well as treatment risks during pregnancy and breastfeeding. Oral topiramate and onabotulinum toxin A injections are the only treatments granted Class A recommendation, while valproate, gabapentin, and tizanidine received Class B recommendation, along with acupuncture, biofeedback, and mindfulness. The anti-CGRP or anti-CGRPr monoclonal antibodies, still unavailable in Brazil, are promising new drugs already approved elsewhere for migraine prophylactic treatment, the efficacy of which in chronic migraine is still to be definitively proven.