Comment on a draft guideline

Current consultations

Current and planned consultations are as follows:

SIGN  155: Pharmacological management of migraine was originally published in 2018

We have updated the guideline to include:

• A new section on oral calcitonin gene-related peptide receptor (CGRP) antagonists for patients with acute migraine (sections 3.7 and 3.10).
• A new section on CGRP antagonists for the prevention of migraine (section 4.5).
• Revised advice on the use of ibuprofen during pregnancy (section 3.3).
• Additional advice on combination therapies for acute migraine (section 3.8).
• A restructure of the section on prevention of migraine (section 4) to reflect changes in prescribing practices and safety advice on the use of sodium valproate and topiramate.

The draft update is here: SIGN 155 Migraine Update Consultation Draft

It contains the revised sections (on a white background) and original text for context (grey background). The full, published guideline, with details of the methodology used to develop it, is available here.

We would be grateful for your comments on the revised sections only.

Please provide feedback on the following points via the online form:

• Do the recommendations reflect the evidence?
• Are there any relevant studies that we have missed? Please supply references to support your comments.
• Are the recommendations appropriate for use in NHSScotland?
• Is the language and presentation of the evidence and recommendations appropriate?

Please submit your feedback by no later than Monday 17 November 2025.