Abstract text (incl. figure legends and references)
Objective: Qualitative assessment of evolution over time in different guidelines for paracetamol use in acute migraine
Methods: The assessment was performed on 10 published guidelines from 5 scientific societies, American Headache Society (AHS), formerly American Academy of Neurology (AAN), French headache society ("Société Française d'Etudes des Migraines et Céphalées" - SFEMC), Canadian Headache Society (CHS), European Federation of Neurological Societies (EFNS), and European Headache Federation (EHF).
Results: The comparison between earlier (1997-2014) and current (2009-2021) guidelines showed an evolution in the level of recommendations for paracetamol use in three of five scientific societies. There was a shift from no recommendation or recommendation only for mild attacks to recommendation for mild to moderate attacks without restriction in updated guidelines. Four of the five scientific societies (AHS, SFEMC, CHS, EFNS) now recommend Paracetamol for mild to moderate attacks. The 5th scientific society (EHF) recommends paracetamol when NSAIDs are contraindicated.
Conclusion: This qualitative analysis emphasizes evolutions in practice guidelines over time in different scientific societies regarding the place of paracetamol in acute migraine. There was a positive evolution in paracetamol recommendations in the latest guidelines. Most guidelines now recommend it for mild to moderate pain.