This toolkit is based on SIGN guideline 155: Pharmacological management of migraine. It includes evidence-based recommendations for best practice in the acute and prophylactic pharmacological management of adults with migraine episodic or chronic migraine. Medication-overuse headache is also covered. Studies of children with migraine were not included, however the recommendations could be considered for treating adolescents with migraine.

The toolkit will be of interest to healthcare professionals in primary and secondary care, including general practitioners, headache nurses, neurologists, out-of-hours clinicians, pharmacists, and patients with migraine.

The application is available as a website and as downloadable mobile applications, via the following link:

Online and

This software is an informational and educational resource. It is not a medical device as defined by the Medical Devices Directive.

SIGN (Scottish Intercollegiate Guidelines Network): SIGN was formed in 1993. Its objective is to improve the quality of health care for patients in Scotland by reducing variation in practice and outcome, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence.

The membership of SIGN includes all the medical specialties, nursing, pharmacy, dentistry, professions allied to medicine, patients, health service managers, social services, and researchers. The work of SIGN is supported by an Executive.

SIGN is part of the Evidence Directorate of Healthcare Improvement Scotland and core funding from Healthcare Improvement Scotland supports the SIGN Executive, and expenses and costs associated with guideline development projects. SIGN is editorially independent from Healthcare Improvement Scotland and the Scottish Government which ultimately funds Healthcare Improvement Scotland.

Content management and governance

SIGN Guideline 155 was published in February 2018 and updated in 2022 and 2023. The app will be updated if any further updates are made to the guideline.

Technical maintenance and updating of the app is carried out by Tactuum Ltd and funded through the National Decision Support Programme led by the Digital Health and Care Institute.


The content within this app/ website is based on current evidence and best practice, however it is intended to be applied alongside sound clinical judgement.  As such, Healthcare Improvement Scotland is not responsible or liable for any diagnosis or management decision made on the basis of the information provided via this app/website.

Use of this app within patient care settings should always be in accordance with local policies and guidance with regard to clinical practice and mobile device usage.

Healthcare Improvement Scotland is not responsible for the content of any external websites listed, nor do they endorse any commercial product or service mentioned or advised on in any of these websites.

All use of this resource is subject to Scots law and the jurisdiction of the Scottish courts and is subject to this disclaimer.  Any views given on the app/website are not necessarily those of Healthcare Improvement Scotland or anyone connected with us.


Copyright information for the two sources of content within this app/website is shown below.

Scottish Intercollegiate Guidelines Network (SIGN).  SIGN 155: Pharmacological management of migraine.  Edinburgh: SIGN; 2023. [cited 04 Apr 2023]  Available from:

Copyright of this guideline is retained by SIGN. Users may download or print copies for their own use and may photocopy guidelines for the purpose of implementation.

This review is licensed under the Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International Licence. This allows for the copy and redistribution of SIGN guidelines as long as SIGN is fully acknowledged and given credit. The material must not be remixed, transformed or built upon in any way. To view a copy of this licence, visit

Please cite the guideline as: Scottish Intercollegiate Guidelines Network (SIGN). Guideline title. Edinburgh: SIGN; Year. [cited dd mmm yyyy]. Available from URL:

Users wishing to use reproduce or republish SIGN material for commercial purposes must seek prior approval for reproduction in any medium by completing the form at

Applicants for such permission should be aware that:

  • SIGN resources do not endorse specific products
  • Reproduction of SIGN material must be verbatim
  • Within marketing material there must be a clear separation between any SIGN material and product specific information or marketing
  • SIGN does not endorse in any way derivative or excerpted materials based on these guidelines, and it cannot be held liable for the content or use of any such adapted products
  • The use of the SIGN name or logo for the purposes of advertising or implied endorsement of any derived product or service is strictly forbidden.

Key contacts

Ailsa Stein - Programme Manager, SIGN.

Kirsty Littleallan - Administrative Officer, SIGN.

Accessibility checks

Content has been checked for accessibility in line with the relevant RDS standard operating procedure.

Content management and governance


The content in this toolkit has been developed by the SIGN guideline group for SIGN 155: Pharmacological management of migraine

Review and approval

Content has been reviewed and approved in line with the SIGN editorial governance process.

Final content was signed off by the SIGN Programme Lead.

The content will be considered for update 3 years from publication. Any minor updates brought to the  attention will be dealt with on an "as needed" basis.

Updates will be reviewed and approved in line with the SIGN editorial governance process.

Content will be updated using the guideline development processes outlined in the SIGN methodology manual, SIGN 50: a guideline developer's handbook.

Content review by clinicians and people with lived experience

The content was reviewed by the clinicians and people with lived experience on the guideline development group.

The SIGN guideline was available for peer review in June 2017. An update to the guideline was peer reviewed in June 2022. All comments received were addressed and responses published on the SIGN website.

The guideline was reviewed by clinical experts from SIGN Council as part of the editorial process.

Evidence base

This toolkit is based on SIGN guideline 155: Pharmacological management of migraine, which includes details on how the guideline was produced. Further information on SIGN methodology is available from SIGN 50: a guideline developer's handbook

Governance sign-off and ongoing development

The content of this toolkit was reviewed by the SIGN editorial team and signed off by the SIGN Programme Lead.

Monitoring and acting on feedback and complaints

The email for the SIGN Programme Manager is available in the "Key contacts" section above and can be used to highlight any feedback or complaints.

Any messages received through the RDS Feedback form will also be forwarded to the Programme Manager.

The Programme Manager will address the feedback. If it requires significant amendments, it will be referred to the SIGN senior management team for consideration for the SIGN work programme.

Risk assessment

The toolkit has been risk assessed, and mitigations put in place where required.

User testing

Prior to publication the toolkit was user tested by the guideline development group.

Editorial Information

Reviewer name(s): Ailsa Stein, SIGN Team .