Second-line Interventions for Migraine in the Emergency Department

A Narrative Review

Farnam Kazi MD; Mallika Manyapu MD; Maha Fakherddine MD; Kumelachew Mekuria MD; Benjamin W. Friedman MD, MS


Headache. 2021;61(10):1467-1474. 

In This Article


In conclusion, a variety of medications are likely to be effective for treatment of migraine refractory to first-line medication, though only scant high-quality data are available to inform this decision. For patients with migraine who fail to improve after treatment with a first-line medication, it is reasonable to use an IV NSAID or IV acetaminophen. Alternatively, clinicians adept at performing a GONB may offer this treatment.