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What Is the Evidence for the Use of Corticosteroids in Migraine?

  • Migraine (R Cowan, Section Editor)
  • Published:
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Abstract

Corticosteroids are widely prescribed for the management of migraine attacks. The earliest clinical studies examining the efficacy of corticosteroid monotherapy for managing migraine attacks date back to 1952. Since then, 26 heterogeneous clinical studies and four meta-analyses have been conducted to assess the efficacy of corticosteroids in either aborting acute migraine attacks, prolonged migraine attacks or recurrent headaches. Most of these (86 %) studies employed different comparator arms with corticosteroids monotherapy administration while some studies (14 %) evaluated adjunctive corticosteroid therapy. The majority of these clinical studies revealed the superior efficacy of corticosteroids as mono- or adjunctive-therapy both for recurrent and acute migraine attacks, while the remaining showed non-inferior efficacy. Different forms of oral and parenteral corticosteroids in either single-dose or short-tapering schedules are prescribed; there are clinical studies supporting the efficacy of both methods. Corticosteroids can be administered safely up to six times annually. Corticosteroids are also useful in managing patients who frequent emergency departments with “medication-seeking behavior.” Migraine patients with refractory headaches, history of recurrent headaches, severe baseline disability, and status migrainosus were found to have the most beneficial response from corticosteroid therapy.

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Compliance with Ethics Guidelines

Conflict of Interest

Dr. Yohannes W. Woldeamanuel declares no potential conflicts of interest.

Dr. Alan M. Rapoport is a consultant for Merck and received honoraria from Allergan.

Dr. Robert P. Cowan is a section editor for Current Pain and Headache Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Stanford Headache Program, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Room H3160, 300 Pasteur Drive, Stanford, CA, 94305-5235, USA

    Y. W. Woldeamanuel & R. P. Cowan

  2. Department of Neurology, The David Geffen School of Medicine at UCLA in Los Angeles, Los Angeles, CA, USA

    A. M. Rapoport

Authors
  1. Y. W. Woldeamanuel
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  2. A. M. Rapoport
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  3. R. P. Cowan
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Correspondence to Y. W. Woldeamanuel.

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This article is part of the Topical Collection on Migraine

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Woldeamanuel, Y.W., Rapoport, A.M. & Cowan, R.P. What Is the Evidence for the Use of Corticosteroids in Migraine?. Curr Pain Headache Rep 18, 464 (2014). https://doi.org/10.1007/s11916-014-0464-x

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