ACP recommends combining triptans with NSAIDs for migraines

The American College of Physicians (ACP) has released new guidelines for treating acute migraines. They recommend using a triptan medication with a nonsteroidal anti-inflammatory drug (NSAID) for adults who experience moderate to severe migraines that do not improve with NSAIDs alone. They also suggest combining a triptan with acetaminophen for those who do not find relief with acetaminophen alone. Migraines are a major health issue, affecting about 16% of people in the U.S., with women being more likely to suffer from them than men. The guidelines were developed based on a comprehensive analysis of various treatments and included numerous studies comparing their effectiveness. The research showed that using a triptan along with an NSAID is more effective than using either treatment alone. This combination leads to better pain relief and reduces the need for additional medications. The ACP emphasized that triptans, NSAIDs, and acetaminophen are all viable options for treating acute migraines. Patient preferences were also taken into account. Findings indicate that patients prioritize pain relief and express a preference for oral medications over other forms. The ACP noted that while triptans can cause side effects like nausea and dizziness, these are usually mild, but they can impact daily life. The guidelines propose a step-care approach. Initially, patients may increase the dose of simple pain relievers. If that doesn’t work, a combination of triptan and an NSAID or acetaminophen can be tried. If these still don’t help, other medications may be considered. The recommendations align closely with those from the International Headache Society, with some differences in treatment strategies. ACP encourages considering individual patient needs when selecting treatments, especially in cases of nausea or specific health conditions. Clinicians are advised to start treatment as soon as symptoms appear and to emphasize healthy lifestyle choices, such as hydration and regular meals. Cost analyses show that the combination treatments are more affordable than some newer options available.