Clinical Guidelines
The Canadian Headache Society (CHS) is pleased to announce the publication of the Updated Migraine Prevention Guidelines, which includes a comprehensive systematic review and meta-analysis. This significant update aims to provide healthcare professionals with the latest evidence-based recommendations for the prevention and management of migraine, a condition that affects millions of Canadians. A much-needed update from the 2012 guidelines.​
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Medrea I. et al. (2024) Updated Canadian Headache Society Migraine Prevention Guideline with Systematic Review and Meta-analysis. The Canadian Journal of Neurological Sciences, 1-23. DOI: 10.1017/cjn.2024.285.
The CHS members have published other guidelines and articles that can be downloaded here:
Guidelines for acute treatment (Worthington CJNS 2013)
Guidelines for acute treatment in the ED (Orr, Cephalalgia 2014)
Review on nutraceuticals (Orr, Cephalagia 2015)
Review on migraine for primary care (Becker, Can Fam Med 2015)
Review on cluster headache (Becker Headache 2013)
Summary on spontaneous hypotension (Amoozegar CJNS 2013)
Clinical Guidance
Migraine Simplified Playbook for Primary Care
​​​​Primary Care Tip Sheet
​Titration Schedule for Preventive Medication​​
Position Statements
The Canadian Headache Society (CHS) provides official guidance to support clinicians in delivering evidence-based, ethical, and comprehensive migraine care. The following advocacy resources outline CHS’s position on key issues in access, coverage, and treatment standards.​​​​​
Emphasizes that migraine care must be holistic, not reduced to procedures alone. It calls on providers to deliver comprehensive, ethical care that includes diagnosis, education, lifestyle strategies, and preventive therapies.
CHS urges policymakers and payers to modernize reimbursement policies to reflect current evidence. CGRP monoclonal antibodies and gepants should be considered first-line preventive treatments, improving outcomes and reducing the burden of migraine.​​​
Highlights the clinical and economic rationale for combination therapy in chronic migraine. CHS stresses the importance of access, noting strong evidence for improved patient outcomes when these treatments are used together.
CHS addresses recent insurance practices denying concurrent coverage of onabotulinumtoxinA (Botox) and CGRP monoclonal antibodies. This letter details the scientific rationale, clinical experience, and cost-effectiveness supporting combined use in refractory chronic migraine.​​