Pharmaceuticals 2010, 3(6), 1966-1987; doi:10.3390/ph3061966
Review

NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data

1email and 2,* email
Received: 27 April 2010; in revised form: 18 May 2010 / Accepted: 11 June 2010 / Published: 17 June 2010
(This article belongs to the collection Non-Steroidal Anti-Inflammatory Drugs)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: Migraine is a common disabling neurological disorder with a serious socio-economical burden. By blocking cyclooxygenase nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the synthesis of prostaglandins, which are involved in the pathophysiology of migraine headaches. Despite the introduction more than a decade ago of a new class of migraine-specific drugs with superior efficacy, the triptans, NSAIDs remain the most commonly used therapies for the migraine attack. This is in part due to their wide availability as over-the-counter drugs and their pharmaco-economic advantages, but also to a favorable efficacy/side effect profile at least in attacks of mild and moderate intensity. We summarize here both the experimental data showing that NSAIDs are able to influence several pathophysiological facets of the migraine headache and the clinical studies providing evidence for the therapeutic efficacy of various subclasses of NSAIDs in migraine therapy. Taken together these data indicate that there are several targets for NSAIDs in migraine pathophysiology and that on the spectrum of clinical potency acetaminophen is at the lower end while ibuprofen is among the most effective drugs. Acetaminophen and aspirin excluded, comparative trials between the other NSAIDs are missing. Since evidence-based criteria are scarce, the selection of an NSAID should take into account proof and degree of efficacy, rapid GI absorption, gastric ulcer risk and previous experience of each individual patient. If selected and prescribed wisely, NSAIDs are precious, safe and cost-efficient drugs for the treatment of migraine attacks.
Keywords: migraine; NSAIDs; acetaminophen; aspirin; randomized controlled trials; experimental data
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MDPI and ACS Style

Pardutz, A.; Schoenen, J. NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data. Pharmaceuticals 2010, 3, 1966-1987.

AMA Style

Pardutz A, Schoenen J. NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data. Pharmaceuticals. 2010; 3(6):1966-1987.

Chicago/Turabian Style

Pardutz, Arpad; Schoenen, Jean. 2010. "NSAIDs in the Acute Treatment of Migraine: A Review of Clinical and Experimental Data." Pharmaceuticals 3, no. 6: 1966-1987.

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