Overview of migraine treatment

Area of Science:

• Neurology
• Pharmacology

Background:

• Migraine is a significant global health issue, ranking as the 19th leading cause of disability worldwide.
• Despite available treatments, many patients do not use migraine-specific medications, and some remain refractory to conventional therapies.

Purpose of the Study:

• To provide a comprehensive overview of migraine management strategies.
• To review current acute and preventive pharmacologic and nonpharmacologic treatment options for migraine headache.
• To highlight novel and investigational medicines for migraine.

Main Methods:

• Literature review of current and emerging migraine treatments.
• Discussion of pharmacologic agents including ergot alkaloids and triptans (serotonin 5-HT1B/1D receptor agonists).
• Exploration of nonpharmacologic interventions and future therapeutic directions.

Main Results:

• Ergot alkaloids and triptans are established acute treatments, though ergots have vasoconstrictive concerns.
• Triptans have revolutionized migraine therapy but are ineffective for up to one-third of patients.
• A significant patient group experiences refractory migraine, necessitating alternative or novel treatments.

Conclusions:

• Effective migraine management requires a multifaceted approach, considering individual patient responses and refractory cases.
• Current treatments offer relief, but ongoing research is crucial for addressing unmet needs in migraine therapy.
• Novel pharmacologic and nonpharmacologic options are under investigation to improve outcomes for all migraineurs.