Level of recommendation and evidence for prophylactic medication used for migraine according to the U.S.,13,19,25 Canadian,15 French4 and EFNS25 guidelines.
| Drug | 2012 U.S. guidelines | Canadian guidelines | French guidelines | EFNS |
|---|---|---|---|---|
| Valproate* | Level A | Weak recommendation, HQE | DE, Grade A methodology | Level A |
| Topiramate* | Level A | Strong recommendation, HQE | DE, Grade A methodology | Level A |
| Carbamazepine* | Level C | Not rated | Not rated | Not rated |
| Gabapentin* | Level U | Strong recommendation, MQE | Doubtful efficacy, Grade B or C methodology | Level C |
| Lamotrigine* | Ineffective | Not rated | Not rated | Not rated |
| Amitriptyline† | Level B | Strong recommendation, HQE | PE, Grade B or C methodology | Level B |
| Venlafaxine† | Level B | weak recommendation, LQE | PE, Grade B or C methodology | Level B |
| Fluoxetine† | Level U | Not rated | Not rated | Not rated |
| Pizotifen† | Not rated | Weak recommendation, HQE | PE, Grade B or C methodology | Not rated |
| Metoprolol† | Level A | Strong recommendation, HQE | DE, Grade A methodology | Level A |
| Propranolol† | Level A | Strong recommendation, HQE | Not rated | Level A |
| Timolol‡ | Level A | Not rated | PE, Grade B or C methodology | Not rated |
| Atenolol‡ | Level B | Not rated | PE, Grade B or C methodology | Not rated |
| Nadolol‡ | Level B | Strong recommendation, MQE | PE, Grade B or C methodology | Not rated |
| Nebivolol‡ | Level C | Not rated | Probable efficacy, Grade B or C methodology | Not rated |
| Acebutolol‡ | Ineffective | Not rated | Not rated | Not rated |
| Verapamil¦ | Level U | Weak recommendation, LQE | Not rated | Not rated |
| Candesartan¦ | Level C | Strong recommendation, MQE | PE, Grade B or C methodology | Level C |
| Lisinopril¦ | Level C | Weak recommendation, LQE | Not rated | Level C |
| Naproxen¦ | Level B | Not rated | PE, Grade B or C methodology | Level B |
| Aspirin** | Level U | Not rated | Not rated | Level C |
| Feverfew** | Level B | Not recommended | Not rated | Not rated |
| Petasites** | Level A | Not rated | Not rated | Level B |
| Butterbur** | Not rated | Strong recommendation, MQE | Not rated | Not rated |
| Coenzyme 10** | Level C | Strong recommendation, LQE | Not rated | Level C |
| Riboflavin** | Level B | Strong recommendation, LQE | Not rated | Level C |
| Magnesium** | Level B | Strong recommendation, LQE | Not rated | Level C |
HQE - high quality evidence, LQE - low quality evidence, MQE - moderate quality evidence, DE - demonstrated efficacy, PE - probable efficacy, EFNS - European Federation of Neurological Societies, U.S. - United States of America, symbols represent different groups of medications