{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T08:04:37Z","timestamp":1789286677903,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Migraine remains a prevalent and disabling condition in older adults, yet there are limited data guiding acute treatment in patients over the age of 65 years. This population is often underrepresented in clinical trials and there are special considerations to take with management in this population including age\u2010related pharmacokinetic changes, comorbidities, and increased risk of medication\u2010related adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this narrative review, we aim to highlight the current acute treatments for migraine and considerations that should be taken when choosing medications in older adults, including assessing vascular risk factors, polypharmacy, declining kidney function, delayed gastric emptying, and impaired liver metabolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a narrative review on the current literature and evidence for the use of acute medications in patients with migraine who are 65\u2009years old or older. The authors queried both PubMed and Google Scholar for relevant publications in February\u2013March 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The authors provide a breakdown of acute medication treatment options and include special considerations by class. The classes discussed include non\u2010steroidal anti\u2010inflammatory drugs, acetaminophen, triptans, ergotamines, gepants, ditans, neuromodulation, and nerve blocks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultimately, effective and safe acute migraine management in patients over age 65\u2009years requires applying the best available evidence, understanding knowledge gaps, and engaging in shared decision making. Better data and guidelines are needed to enable clinicians to make informed treatment decisions and to safely provide reassurance to patients who benefit from these therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70177","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:57:08Z","timestamp":1784098628000},"page":"1898-1905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute migraine treatments in patients above age 65"],"prefix":"10.1111","volume":"66","author":[{"given":"Tulsi","family":"Shah","sequence":"first","affiliation":[{"name":"Capital Neurology and Sleep Medicine  McLean Virginia USA"},{"name":"Department of Neurology MedStar Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ailani","sequence":"additional","affiliation":[{"name":"Department of Neurology 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