Acupuncture effective for migraine prophylaxis

Clinical question: 
How effective is acupuncture for prophylaxis of migraine?
Bottom line: 
Six trials compared acupuncture to no prophylactic treatment or routine care only. After 3 to 4 months, patients receiving acupuncture had higher response rates and fewer headaches. The only study with long term follow-up saw no evidence that effects dissipated up to 9 months after cessation of treatment. Four trials compared acupuncture to proven prophylactic treatment. Overall, in these trials acupuncture was associated with slightly better outcomes and fewer adverse effects than prophylactic drug treatment. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.
Caveat: 
Fourteen trials compared a “true” acupuncture intervention with a variety of sham interventions. Pooled analysis did not show a statistically significant superiority for true acupuncture for any outcome in any of the time windows, but the results of single trials varied considerably. The correct placement of needles seems to be less relevant than is usually thought by acupuncturists.
Context: 
Migraine is a disorder with recurrent headaches manifesting in attacks lasting 4 to 72 hours. It is a common disorder, with a 1-year prevalence of about 10% to 12% and a lifetime prevalence of between 15% and 20%.1 Acupuncture is often used for migraine prophylaxis but its effectiveness is still controversial.
Review CD#: 
CD001218
PEARLS No: 
133
Date: 
March, 2009
Authored by: 
Brian R McAvoy