Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II
Paulo Sergio Faro Santos, Eliana Meire Melhado, Alexandre Ottoni Kaup, Aline Turbino Neves Martins da Costa, Célia Aparecida de Paula Roesler, Élcio Juliato Piovesan, Elder Machado Sarmento, Giselle Oliveira Martins Theotonio, Henrique Carneiro de Campos, Ida Fortini, Jano Alves de Souza, Jayme Antunes Maciel Júnior, João Batista Alves Segundo, João José Freitas de Carvalho, José Geraldo Speziali, Leandro Cortoni Calia, Liselotte Menke Barea, Luiz Paulo Queiroz, Marcio Nattan Portes Souza, Marcos Ravi Figueiredo, Maria Eduarda Nobre, Mário Fernando Prieto Peres, Mauro Eduardo Jurno, Patrícia Machado Peixoto, Pedro André Kowacs, Pedro Augusto Sampaio Rocha‐Filho, Pedro Ferreira Moreira Filho, Raimundo Pereira Silva-Neto, Yára Dadalti Fragoso
Abstract
BACKGROUND: Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. OBJECTIVE: The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. METHODS: Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. RESULTS: From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. CONCLUSIONS: Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.