CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(08): 845-861
DOI: 10.1055/s-0042-1756441
Brazilian Academy of Neurology

Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I

Consenso da Sociedadade Brasileira de Cefaleia (SBCe) para o tratamento profilático da migrânea episódica: parte I
2   Centro Universitário Padre Albino, Faculdade de Medicina, Departamento de Neurologia, Catanduva SP, Brazil.
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1   Instituto de Neurologia de Curitiba, Departamento de Neurologia, Setor de Cefaleia e Dor Orofacial, Curitiba PR, Brazil.
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3   Houston Headache Clinic, Houston TX, United States.
4   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.
5   Universidade de Santo Amaro, São Paulo SP, Brazil.
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6   Hospital Santa Marcelina, São Paulo SP, Brazil.
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7   Q2 Centro Médico de Neurologia, Depto de Neurologia, São Paulo SP, Brazil.
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8   Universidade Federal do Paraná, Departamento de Clínica Médica, Disciplina de Neurologia, Curitiba PR, Brazil.
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9   Universidade Federal Fluminense, Rio de Janeiro RJ, Brazil.
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10   Universidade Federal do Rio de Janeiro, Centro de Pesquisas, Rio de Janeiro RJ, Brazil.
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11   Clínica Neurológica, Belo Horizonte MG, Brazil
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12   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
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13   Universidade Federal Fluminense, Departamento de Medicina Clínica, Disciplina de Neurologia, Niterói RJ, Brazil.
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14   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.
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15   Centro Integrado de Saúde Lineu Araújo, Ambulatório de Neurologia, Teresina PI, Brazil.
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16   Unichristus, Curso de Medicina, Disciplina de Neurologia, Fortaleza CE, Brazil.
17   Hospital Geral de Fortaleza, Serviço de Neurologia, Núcleo de Cefaleias, Fortaleza CE, Brazil.
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18   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurologia, Ribeirão Preto SP, Brazil.
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19   Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo SP, Brazil.
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20   Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Disciplina de Neurologia, Porto Alegre RS, Brazil.
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21   Universidade Federal de Santa Catarina, Hospital Universitário, Serviço de Neurologia, Florianópolis SC, Brazil.
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22   Universidade de São Paulo, Hospital das Clínicas, Depto de Neurologia, São Paulo SP, Brazil.
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23   Hospital Universitário Antônio Pedro, Serviço de Neurologia, Niterói RJ, Brazil.
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9   Universidade Federal Fluminense, Rio de Janeiro RJ, Brazil.
24   Universidade Federal do Rio de Janeiro, Rio de Janeiro RJ, Brazil.
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25   Hospital Israelita Albert Einstein, Departamento de Neurologia, São Paulo SP, Brazil.
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26   Fundação José Bonifácio Lafayette de Andrada, Faculdade de Medicina de Barbacena, Barbacena MG, Brazil.
27   Fundação Hospitalar do Estado de Minas Gerais, Hospital Regional de Barbacena Dr. José Américo, Barbacena MG, Brazil.
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28   Secretaria de Estado da Saúde do Distrito Federal, Brasília DF, Brazil.
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29   Instituto de Neurologia de Curitiba, Serviço de Neurologia, Curitiba PR, Brazil.
30   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Neurologia, Curitiba PR, Brazil.
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31   Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área de Neuropsquiatria, Recife PE, Brazil.
32   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Ambulatório de Cefaleias, Recife PR, Brazil.
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33   Universidade Federal Fluminense, Hospital Universitário Antônio Pedro, Departamento de Medicina Clínica, Niterói RJ, Brazil.
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34   Universidade Federal do Pará, Belém PA, Brazil.
35   Universidade do Estado do Pará, Belém PA, Brazil.
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36   Universidade Metropolitana de Santos, Santos SP, Brazil.
› Author Affiliations

Abstract

The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.

Resumo

A Sociedade Brasileira de Cefaleia (SBCe) nomeou um Comitê de Autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da enxaqueca episódica com base em artigos da literatura mundial e da experiência pessoal. A enxaqueca é um distúrbio subdiagnosticado e subtratado que acomete um bilhão de pessoas no mundo e mais de 30 milhões de brasileiros. É conhecido na comunidade médica de neurologistas e, sobretudo, dos especialistas em cefaleia, a necessidade de se divulgar o conhecimento sobre o tratamento profilático da enxaqueca. Com esta finalidade, aliada às necessidades de atualizações de drogas e de se aumentar o conhecimento sobre a doença em si (frequência, intensidade, duração, impacto e talvez a progressão da enxaqueca), foi elaborado este Consenso, com metodologia totalmente on-line, por 12 grupos que revisaram e escreveram sobre as categorias farmacológicas das drogas e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de drogas estudadas para este Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais do antipeptídeo relacionado ao gene da calcitonina (peptídeo relacionado ao gene da calcitonina — anti-CGRP), betabloqueadores, anti-hipertensivos, inibidores dos canais de cálcio, outros antidepressivos (inibidores seletivos de recaptação de serotonina, ISRSs, e antidepressivos de ação dual), outras drogas, e politerapia. O tratamento hormonal, bem como anti-inflamatórios e triptanas em esquema de profilaxia mínima (miniprofilaxia), será abordado em um capítulo próprio. As classes de drogas estudadas na parte I do Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais anti-CGRP, e betabloqueadores.

Authors' contributions:

EMM, PAK: discussion, group coordination, writing, review, conceptualization, editing, data collection; PSFS: discussion, group coordination, writing, review, conceptualization; AOK, ATNMC, CAPR, EMS, GOMT, IF, LCC, LMB, MFPP, PMP, PFMF: writing, review, discussion, conceptualization; EJP, JJFC, HCC: writing, review, editing, group coordination, discussion; JAS, LPQ, MNPS: writing, review, editing, discussion; JAMJ, MENMC: writing, review, discussion; JBAS: writing, discussion; JGS: writing; MRCFF, MEJ, YDF: writing, review; PASRF: conceptualization, data collection, writing, review, editing.




Publication History

Received: 11 December 2021

Accepted: 24 May 2022

Article published online:
17 October 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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