2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Headache
The revised CPG includes 52 recommendations on evaluation, pharmacotherapy, invasive interventions, and nonpharmacologic interventions for selected primary and secondary headache disorders. In addition to triptans and aspirin-acetaminophen-caffeine, newer calcitonin gene-related peptide (CGRP) inhibitors (gepants) are options for treatment of acute migraine. Medications to prevent episodic migraine (EM) include angiotensin-receptor blockers, lisinopril, magnesium, topiramate, valproate, memantine, the newer CGRP monoclonal antibodies, and atogepant. AbobotulinumtoxinA can be used for prevention of chronic migraine but not EM. Gabapentin is not recommended for prevention of EM. Ibuprofen (400 mg) and acetaminophen (1000 mg) can be used for treatment of TTH, and amitriptyline for prevention of chronic TTH. Physical therapy or aerobic exercise can be used in management of TTH and migraines.
Authors
- James Reston (ORCID: https://orcid.org/0000-0003-4997-3754)
- Andrew Buelt
- Karen M. Skop (ORCID: https://orcid.org/0000-0002-1738-7972)
- Jason J. Sico (ORCID: https://orcid.org/0000-0001-5358-2735)
- Natasha Antonovich
- Franz J. Macedo
- Amanda Ford
- Thomas R. Stark (ORCID: https://orcid.org/0000-0002-4986-6417)
- Friedhelm Sandbrink (ORCID: https://orcid.org/0000-0002-3786-7244)
- Jennifer Ballard‐Hernandez (ORCID: https://orcid.org/0000-0003-1657-1476)
- Amy S. Grinberg (ORCID: https://orcid.org/0000-0003-4141-9513)
- James Sall (ORCID: https://orcid.org/0000-0001-8564-1314)
- Rebecca Vogsland (ORCID: https://orcid.org/0000-0003-4928-2793)
- Lisa Wayman (ORCID: https://orcid.org/0000-0001-6939-0279)
- Ian W. Pace (ORCID: https://orcid.org/0000-0002-4243-6027)
Institutions
- ECRI Institute (US)
- Brooke Army Medical Center (US)
- Wright-Patterson Air Force Base (US)
- Edward Hines, Jr. VA Hospital (US)
- VA Connecticut Healthcare System (US)
- James A. Haley Veterans' Hospital (US)
- Bay Pines VA Healthcare System (US)
- Minneapolis VA Health Care System (US)
- United States Army Institute of Surgical Research (US)
- Office of Patient Care Services (US)
- Minneapolis VA Medical Center (US)
- South Texas Veterans Health Care System (US)
- Washington DC VA Medical Center (US)
- Joint Base San Antonio (US)
Publication Details
- Journal
- Annals of Internal Medicine
- Published
- 2024-10-28
- DOI
- https://doi.org/10.7326/annals-24-00551
- Citations
- 9
- Primary Topic
- Migraine and Headache Studies
- Type
- article
- Field-Weighted Citation Impact
- 3.47