Materiały źródłowe

• #1 Migraine – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207

  Migraine treatment is aimed at stopping symptoms and preventing future attacks. […] Many medications have been designed to treat migraines. Medications used to combat migraines fall into two broad categories: Pain-relieving medications, also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms. […] Preventive medications, these types of drugs are taken regularly, often daily, to reduce the severity or frequency of migraines. […] Your treatment choices depend on the frequency and severity of your headaches, whether you have nausea and vomiting with your headaches, how disabling your headaches are, and other medical conditions you have. […] Medications used to relieve migraine pain work best when taken at the first sign of an oncoming migraine as soon as symptoms of a migraine begin.

• #2 Acute Treatment for Migraine | American Headache Society

  https://americanheadachesociety.org/resources/primary-care/acute-treatment-for-migraine

  There is no universal method for managing migraine, and treatment varies from patient to patient. […] What acute and preventive medication options are there for people living with migraine? […] When treating migraine, there are two main forms of medication to manage symptoms: over-the-counter medications, such as ibuprofen, and prescription medications, such as triptans. […] Pfizer Inc. today announced the U.S. Food and Drug Administration (FDA) has approved ZAVZPRET (zavegepant), the first and only calcitonin gene-related peptide (CGRP) receptor antagonist nasal spray for the acute treatment of migraine with or without aura in adults. […] Treating migraine is a complex issue, as there is no cure nor is there a strictly defined way to manage the disease. […] Objective: To provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine.

• #3 Acute treatment of migraine in adults – UpToDate

  https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults

  Acute treatment of migraine in adults […] The acute treatment of migraine in adults is reviewed here. […] The abortive (symptomatic) therapy of migraine ranges from the use of simple analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to triptans, antiemetics, calcitonin gene-related peptide (CGRP) antagonists, lasmiditan, and dihydroergotamine. […] Noninvasive neuromodulation devices are typically used for patients who do not respond to or tolerate drug treatments and those who wish to avoid medications. […] Abortive treatments are more effective if they are given early in the course of the headache; a large single dose tends to work better than repetitive small doses. […] General recommendations for the treatment of acute migraine include the following.

• #4 Migraine Headache Treatment & Management: Approach Considerations, Emergency Department Considerations, Reduction of Migraine Triggers

  https://emedicine.medscape.com/article/1142556-treatment

  Migraine treatment involves acute (abortive) and preventive (prophylactic) therapy. Patients with frequent attacks usually require both. Measures directed toward reducing migraine triggers are also generally advisable. […] Acute treatment aims to reverse, or at least stop, the progression of a headache that has started. Preventive treatment, which is given even in the absence of a headache, aims to reduce the frequency and severity of the migraine attack, make acute attacks more responsive to abortive therapy, and perhaps also improve the patient’s quality of life. […] Migraineurs should be screened for cardiovascular risk factors, which, if present, should be aggressively treated. Migraineurs with aura should also be counseled on the increased risk of stroke with smoking and oral contraceptive use.

• #5 Migraine Treatments, Preventative Meds & Abortive Drugs

  https://www.webmd.com/migraines-headaches/migraine-treatments

  Drugs for migraine headaches can relieve the pain and symptoms of a migraine attack and help prevent further migraine attacks. […] Migraines can be treated with two types of drugs: abortive and preventive. […] The goal of acute treatment — also called abortive treatment — is to stop a migraine once it starts. […] Acute medications stop a migraine when you feel one coming or once it has begun. […] Prescription NSAIDS (non-steroidal anti-inflammatory drugs) include celecoxib (Elyxyb), diclofenac potassium (Cambia), indomethacin (Indocin). […] Other acute treatments include the triptans and ditans, which specifically target serotonin. […] If your migraine attacks last a long time — 72 hours or more — your doctor may prescribe the steroid drug prednisone to shorten them. […] This type of treatment is considered if migraines occur frequently, typically more than one migraine per week, or if migraine symptoms are severe.

• #6 Acute Migraine Headache: Treatment Strategies | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0215/p243.html

  Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line treatments for mild to moderate migraines, whereas triptans are first-line treatments for moderate to severe migraines. Although triptans are effective, they may be expensive. Other medications such as dihydroergotamine and antiemetics are recommended for use as second- or third-line therapy for select patients or for those with refractory migraine. The pharmacologic properties, potential adverse effects, cost, and routes of administration vary widely, allowing therapy to be individualized based on the pattern and severity of attacks. Several treatment principles, including taking medication early in an attack and using a stratified treatment approach, can help ensure that migraine treatment is cost-effective.

• #7 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Migraine treatment and prevention […] Theres no cure for migraine. There are treatments available to help reduce the symptoms. […] During an attack, many people find that sleeping or lying in a darkened room can help. […] It may take time to work out the best treatment for you. You may need to try different types or combinations of medicines before you find the most effective ones. […] If you cant manage your migraine headaches using over-the-counter medicines, your GP may prescribe something stronger. […] Many people find that over-the-counter painkillers, like paracetamol, aspirin or ibuprofen, can help to reduce their symptoms. […] They tend to be most effective if taken at the first signs of a migraine attack. […] You shouldnt wait until the headache worsens before taking painkillers as its often too late for the medication to work. […] Taking too many painkillers can lead to medication overuse headache. […] If you cant swallow painkillers because of nausea or vomiting, you should speak to your GP about anti sickness medication or suppository options.

• #8 Migraine Treatment: A Comprehensive Guide – Southern Pain Society

  https://southernpainsociety.org/migraine-treatment-comprehensive-guide/

  Feverfew, Petadolex (butterbur), and magnesium oxide have all proven effective in double-blind studies as migraine preventives. […] Topiramate is an effective migraine preventive, without the weight gain commonly encountered with the other meds. […] Valproate, or divalproex sodium, (Depakote) is a long-time staple, popular for migraine prevention. […] The -blocker propranolol also is FDA-approved as a preventive agent for migraines. […] Amitriptyline is an effective, inexpensive agent that is useful for the prevention of daily headaches and insomnia. […] Naproxen is a very useful agent for the treatment of daily headaches, as well as for younger women suffering from menstrual migraine. […] There are a number of second-line migraine treatments. […] Polypharmacy is common in migraine prevention.

• #9 Migraine Treatment: A Comprehensive Guide – Southern Pain Society

  https://southernpainsociety.org/migraine-treatment-comprehensive-guide/

  For patients who cannot tolerate triptans, there are a number of other effective non-triptan first-line approaches, including diclofenac potassium powder (Cambia), Excedrin Migraine, naproxen, ketorolac (po/IM/nasal: Sprix nasal spray), ibuprofen, and Prodrin (similar to Midrin, but without the sedative). […] In general, drugs containing ergotamine (also called ergots) are effective second-line therapy for migraines. […] A new therapy has emerged, transcranial magnetic stimulation (TMS). The patient uses a hand-held device applied to the back of the head, for an acute migraine attack. […] Botulinum toxin A (Botox) has been studied extensively in patients with migraines. Nearly 4 million people have had botulinum toxin A injections for headache. Botulinum toxin A has been found to significantly improve quality of life and reduce headache impact. Botox is the only botulinum toxin A FDA-approved for treatment of chronic migraine.

• #10 Acute Treatments for Episodic Migraine | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/migraine-treatments/protocol

  Opiates and butalbital-containing medications have a two-fold higher risk of MOH development compared to simple analgesics and triptans. […] For this reason, the American Headache Society has explicitly stated that opioids and butalbital-containing drugs should not be used as first-line treatment for migraine and other recurrent headache disorders, and guidelines recommend that triptans and simple analgesics should be tried first. […] Additionally, the use of opioids for the acute treatment of migraine has been identified as a risk factor for disease chronification. […] Despite concern with use of opioids for migraine management, they are still often prescribed across all age groups. […] This systematic review will address the critical evidence gaps and decisional dilemma by assessing the comparative effectiveness and harms for acute migraine treatments, including opioid therapy, nonopioid pharmacologic therapy, and nonpharmacologic therapy.

• #11 Migraine Treatments | What Options Do You Have?

  https://www.migrainedisorders.org/migraine-disorders/migraine-treatments/

  Migraine treatments can be approached in three different ways: treating the symptoms when they occur (acute intervention), using treatment routinely to reduce the intensity and frequency of migraine attacks (preventive or prophylactic treatments), and non-medicinal approaches such as tracking migraine triggers and lifestyle modifications. […] Acute treatments are used when a migraine attack occurs. […] Prescription medications called triptans are the current gold-standard for acute migraine treatment, but they are not safe or effective for every person. […] People with migraine disease will need at least one acute treatment they can count on to reduce or stop the symptoms of an attack. […] If you need to use acute medications more than 2 headache days per week, then your provider may consider starting preventive treatment.

• #12 Which migraine medications are most helpful? – Harvard Health

  https://www.health.harvard.edu/blog/which-migraine-medications-are-most-helpful-202402053014

  Drugs known as triptans came out on top, based on real-world data from some 278,000 migraine sufferers. […] A recent study suggests a class of drugs called triptans are the most helpful option, with one particular drug rising to the top. […] The researchers looked at 25 medications from seven drug classes to see which were most helpful for easing migraines. After triptans, the next most helpful drug classes were ergots such as dihydroergotamine (Migranal, Trudhesa) and anti-emetics such as promethazine (Phenergan). […] „If you had asked me to sit down and make a list of the most helpful migraine medications, it would be very similar to what this study found,” she says. […] Triptans scored five to six times more helpful than ibuprofen. The highest ranked drug, eletriptan, helped 78% of the time. Other triptans, including zolmitriptan (Zomig) and sumatriptan (Imitrex), were helpful 74% and 72% of the time, respectively.

• #13 What are the new drugs for the treatment of migraine?

  https://www.drugs.com/medical-answers/new-drugs-treatment-prevention-migraine-3515053/

  Sumatriptan is a well-established migraine treatment first approved in subcutaneous injection form under the brand name Imitrex in 1992. […] Rizatriptan was first approved in an oral tablet formulation under the brand name Maxalt, and an orally disintegrating tablet formulation under the brand name Maxalt-MLT in 1998. […] Dihydroergotamine was first approved in injection form under the brand name D.H.E. 45 in 1946 and as a nasal spray under the brand name Migranal in 1997. […] The following drugs are FDA approved for the acute treatment of migraine with or without aura in adults. […] The newest drugs for the prevention of migraine belong to the class of drugs called calcitonin gene-related peptide (CGRP) antagonists and include Aimovig, Ajovy, Emgality, Vyepti, Nurtec ODT, and Qulipta. […] Nurtec ODT is a dual therapy used for both acute and preventive treatment of migraine. […] Qulipta is taken once daily for the preventive treatment of episodic and chronic migraine. […] The following drugs are FDA approved for the preventive treatment of migraine in adults.

• #13 What are the new drugs for the treatment of migraine?

  https://www.drugs.com/medical-answers/new-drugs-treatment-prevention-migraine-3515053/

  The newest novel drug (approved March 9, 2023) for the treatment of migraine is Zavzpret (zavegepant) nasal spray. […] The newest drug for the acute treatment of migraine is Zavzpret (zavegepant) nasal spray. […] The newest oral drugs for the acute treatment of migraine are Nurtec ODT (rimegepant) and Ubrelvy (ubrogepant), both orally-administered calcitonin gene-related peptide (CGRP) receptor antagonists (gepants). […] Another new drug for the acute treatment of migraine is Reyvow (lasmiditan), the first serotonin (5-HT)1F receptor agonist. […] The other new drugs for the acute treatment of migraine are novel formulations of older drugs such as sumatriptan and rizatriptan, belonging to the class of drugs called serotonin (5-HT) receptor agonists (triptans), and dihydroergotamine, an ergotamine derivative.

• #14 Migraine Treatment and Relief (Triptans)

  https://patient.info/brain-nerves/migraine-leaflet/migraine-treatment-medication-and-prevention

  Medicines which are used to treat migraine attacks (episodes) include painkillers, anti-inflammatory painkillers, anti-sickness medicines and triptans. […] Most people with migraine can find a treatment that works reasonably well for most attacks. However, children, and pregnant and breastfeeding women have a limited choice as many anti-migraine and anti-sickness medicines are not suitable for them. […] There are four types of medicines that are commonly used to treat migraine attacks: Ordinary painkillers – eg, paracetamol. Anti-inflammatory painkillers – eg, aspirin, ibuprofen. Anti-sickness medicines – eg, domperidone, prochlorperazine. Triptans – eg, almotriptan, naratriptan, sumatriptan, zolmitriptan. […] A triptan is an alternative if painkillers or anti-inflammatory painkillers do not help much. Triptans are a group (class) of medicines that are used to ease the symptoms of a migraine attack or cluster headache.

• #15 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  If over the counter medication is not helping your symptoms, your GP might recommend a triptan and/or anti sickness medication. […] Triptan medicines are a specific painkiller for migraine headaches. […] Common side effects of triptans include: warm sensations, tightness, tingling, flushing and light headedness, feelings of heaviness in the face, throat, limbs or chest. […] Taking too many triptans can lead to medication overuse headache. […] Medication is available to help prevent migraine attacks. Preventive medication is normally used if your migraine headaches remain frequent (more than 1 migraine attack per week) following a period of avoiding possible triggers. […] Preventive medication is not a cure for migraine attacks. The aim is to reduce how severe and often migraine attacks occur.

• #16 New Treatment Options for Headaches | Cedars-Sinai

  https://www.cedars-sinai.org/blog/new-headache-treatment-options.html

  These innovations open the door for migraine patients with heart disease, stroke and vascular diseases, who couldn’t safely take the older class of triptan migraine medications. […] Botox is FDA-approved for chronic migraines in adults who have at least 15 headache days a month with each headache lasting four or more hours. […] Trigger point injections target muscles to address co-occurring myofascial and chronic neck and shoulder pain, and nerve blocks address concurrent neuralgias and help break up frequent headache cycles. […] If you’re experiencing painful migraines or other types of severe or chronic headaches, see your primary care doctor or a neurologist. They can refer you to a headache specialist for specialized care such as injections. […] There are individualized treatment plans available to help alleviate chronic headaches and improve your quality of life.

• #17 New Treatments for Migraine | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/new-migraine-treatments/

  Triptans are commonly used for immediate migraine relief, but advancements in migraine research have led to the discovery of other oral medications, such as gepants, which are medications that target and reduce CGRP (calcitonin gene-related peptide, a protein that causes inflammation in the brain). […] Another new class of medications is the ditans like lasmiditan (REYVOW®). While gepants work outside the brain, lasmiditan goes into the brain and essentially “turns off” the migraine during an acute attack. […] Finally, while many people with migraine use over-the-counter NSAIDs, like ibuprofen, these can take time to work and aren’t always effective for everyone. […] Dihydroergotamine, also known as DHE, is an option when triptans are not effective. It comes in various formulations, including injection, infusion and nasal spray.

• #18 Treatment of Migraine | Nurtec® ODT (rimegepant) | Safety Info

  https://www.nurtec.com/

  In a study of Nurtec ODT to treat migraine attacks: […] Pain relief: 59.3% of people taking Nurtec ODT experienced pain relief at 2 hours postdose (vs 43.3% with placebo). Pain relief was sustained in 42.2% of people taking Nurtec ODT at 48 hours (vs 25.2% with placebo). […] Pain freedom: 21.2% of people taking Nurtec ODT experienced pain freedom at 2 hours postdose (vs 10.9% with placebo). Pain freedom was sustained in 13.5% of people taking Nurtec ODT at 48 hours (vs 5.4% with placebo). […] Freedom from most bothersome symptom: 35.1% of people taking Nurtec ODT experienced freedom from their most bothersome symptom (light sensitivity, sound sensitivity, or nausea) at 2 hours postdose (vs 26.8% with placebo). […] In a study of Nurtec ODT to prevent migraine attacks: […] Reduction in monthly migraine days (MMDs): When taken every other day, Nurtec ODT can reduce the number of migraine days in a month. People taking Nurtec ODT experienced 4.3 fewer MMDs during weeks 9-12 (vs 3.5 fewer MMDs with placebo). […] The safety of using more than 18 doses in a 30-day period has not been established. You should not take more than 1 tablet in 24 hours.

• #19 Migraine Headache Treatment & Management: Approach Considerations, Emergency Department Considerations, Reduction of Migraine Triggers

  https://emedicine.medscape.com/article/1142556-treatment

  Numerous abortive medications are used for migraine. The choice for an individual patient depends on the severity of the attacks, associated symptoms such as nausea and vomiting, comorbid problems, and the patient’s treatment response. […] The 2 categories of migraine-specific oral medications are triptans and ergot alkaloids. […] In October 2019, the FDA approved lasmiditan for treatment of acute migraine with or without aura. […] Zavegepant intranasal (Zavzpret) is the first intranasal CGRP antagonist approved for adults to treat acute migraine with or without aura. […] Antiemetics (eg, chlorperazine, promethazine) are used to treat the emesis associated with acute migraine attacks. […] The following may be considered indications for prophylactic migraine therapy: Frequency of migraine attacks is greater than 2 per month; Duration of individual attacks is longer than 24 hours; The headaches cause major disruptions in the patients lifestyle, with significant disability that lasts 3 or more days; Abortive therapy fails or is overused; Symptomatic medications are contraindicated or ineffective; Use of abortive medications more than twice a week.

• #20

  https://www2.hse.ie/conditions/migraine/treatment-and-prevention/

  Your GP may recommend triptan medicines if other painkillers do not work. […] Triptans can help to narrow blood vessels in the brain that get wider during a migraine attack and block pain signals in the brain. […] Your GP may prescribe anti-sickness medicines. They are also called anti-emetics. […] Anti-sickness medicines can help if you have symptoms of nausea or vomiting and improve how your body absorbs other medicines, such as painkillers. […] You can buy some combination medicines without a prescription at a pharmacy. […] If medicines to treat or prevent migraine do not help, your GP may refer you to a migraine clinic. […] Treatment at a clinic depends on your symptoms, general health and how often you have migraine attacks. […] Limit using medicines to treat migraine when you’re pregnant or breastfeeding.

• #21 Online Migraine Medication Prescriptions & Treatment

  https://www.lemonaidhealth.com/services/migraine

  Preventive treatments aim at reducing the intensity, duration, and frequency of the attacks. […] The other type of migraine treatment aims at reducing the intensity, duration, and frequency of the attacks. These options address the physiological progression that culminates in a migraine. […] Triptans are often used as a first-line prescription treatment. These migraine medications are vasoconstrictors, meaning that they help constrict blood vessels. […] The Lemonaid migraine service includes the following drugs: Triptans like Imitrex (sumatriptan) or Maxalt (rizatriptan), Anti-nausea medicines like metoclopramide (Reglan), ondansetron (Zofran), and ondansetron ODT (Zofran ODT), Preventive treatments, like amitriptyline, metoprolol, propranolol, and topiramate. […] Botox is FDA-approved for the treatment of chronic migraines. Botulinum toxin, the neurotoxin present in Botox, is administered as an injection. […] If you’re struggling with headaches, there is relief available. Lemonaid can help by prescribing both acute and preventive migraine meds, as well as medications to help with nausea.

• #22 Migraine Headache Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/1142556-guidelines

  According to guidelines released by the American Academy of Neurology (AAN) and the American Headache Society (AHS), the following medications are established as effective and should be offered for migraine prevention (level A recommendation): Antiepileptic drugs (AEDs): divalproex sodium, sodium valproate, topiramate […] The following therapy is established as effective and should be offered for migraine prevention (level A recommendation): Petasites (butterbur) […] In 2016, the American Headache Society (AHS) released guidelines for the management of adults with acute migraine in the emergency department. They recommend intravenous metoclopramide, intravenous prochlorperazine, and subcutaneous sumatriptan to treat these patients (level B recommendation). Dexamethasone should be offered to these patients to prevent recurrence of headache (level B). Opioids (injectable morphine and hydromorphone) should be avoided.

• #23 Migraine Treatments, Preventative Meds & Abortive Drugs

  https://www.webmd.com/migraines-headaches/migraine-treatments

  Medication to prevent a migraine can be taken daily. […] Preventive treatment medications include the following: medications used to treat high blood pressure, antidepressants, anti-seizure medications, CGRP inhibitors used to block the calcitonin gene-related peptide, and Botox. […] Many people who have migraines often have nausea and vomiting along with head pain. […] In these cases, a nausea drug can ease your symptoms so you can get the treatment you need. […] If you can’t take medication or wish not to, a device might be worth considering. […] Some nontraditional supplement treatments for migraine prevention include certified PA-free butterbur, coenzyme Q10, and feverfew.

• #24 Which migraine medications are most helpful? – Harvard Health

  https://www.health.harvard.edu/blog/which-migraine-medications-are-most-helpful-202402053014

  Ergots were rated as three times more helpful than ibuprofen. […] Anti-emetics were 2.5 times as helpful as ibuprofen. […] „For these people, injectable triptans are a game changer because pills don’t work as fast and might not stay down,” she says. […] If you’re using over-the-counter drugs, consider trying a prescription triptan, Dr. Loder says. If nausea and vomiting are a problem for you, be sure to have an anti-nausea drug on hand.

• #25 Acute Migraine Headache: Treatment Strategies | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0215/p243.html

  Strong evidence supports the use of acetaminophen and oral NSAIDs such as aspirin, diclofenac, ibuprofen, and naproxen as first-line treatments for mild to moderate migraine attacks. […] Triptans are an effective first-line treatment for moderate to severe migraine. […] Triptans may not be effective in all patients or all migraine episodes. Repeating the same dose of the same medication may not relieve persistent symptoms. […] Several other medications have good evidence of effectiveness for migraine. However, they are reserved as second-line agents because of adverse effects, route of administration, cost, or abuse potential. […] Parenteral dihydroergotamine (DHE 45) is commonly used to treat refractory migraine. However, vasoconstrictive agents should be avoided for 24 hours after administration of a triptan.

• #26 Migraine – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207

  Medications can help prevent frequent migraines. Your health care provider might recommend preventive medications if you have frequent, long-lasting or severe headaches that don’t respond well to treatment. […] Preventive medication is aimed at reducing how often you get a migraine, how severe the attacks are and how long they last. […] Ask your health care provider if these medications are right for you. Some of these medications are not safe to take during pregnancy. If you’re pregnant or trying to get pregnant, don’t use any of these medications without first talking with your provider.

• #27 Migraine Treatments | What Options Do You Have?

  https://www.migrainedisorders.org/migraine-disorders/migraine-treatments/

  Medication adaptation headache can occur when NSAIDS are used 15 or more times per month. […] Preventive therapy is recommended for those who experience attacks that interfere with daily life despite acute treatment, prefer to be on a preventive treatment regimen, or need to take acute treatments too frequently. […] Preventive treatments aim to reduce the frequency, severity, and disability of attacks. […] Preventive treatment is considered a success if it reduces both the number of migraine days you have and the severity of your attacks by at least 50 percent, without intolerable side effects. […] There are also many medications used “off-label” for migraine treatments that are not FDA-approved for migraine such as certain antidepressants, vitamins, supplements and more. […] Many neuromodulation devices are also cleared by the FDA for the acute and/or preventive treatment of migraine.

• #28 Migraine Overview and Summary of Current and Emerging Treatment Options

  https://www.ajmc.com/view/migraine-overview-and-summary–of-current-and-emerging-treatment-options

  Preventive migraine therapy is used daily to reduce the frequency, severity, and duration of migraine attacks. Preventive therapy should be considered for patients with migraines who routinely have more than 6 headache-days per month, or in other special circumstances, such as recurring migraines producing disability, acute therapies that are ineffective or contraindicated, when serious adverse reactions are produced, or even when it is the patients preference. Preventive migraine agents that are FDA approved include propranolol, timolol, divalproex sodium, and topiramate. Other agents possess established efficacy, but lack FDA approval. Current guidelines address which agents are effective in migraine prevention, but a lack of evidence prohibits the ability on how to choose 1 option over another. Preventive therapy is chosen based on adverse effect profiles and the patients coexisting comorbidities (eg, comorbid hypertension can be treated with propranolol or timolol; comorbid depression or insomnia can be treated with tricyclic antidepressants; comorbid seizure disorders or bipolar disorder can be treated with anticonvulsants). Full therapeutic effects take up to 6 months to be achieved.

• #29 Migraine Headache Treatment & Management: Approach Considerations, Emergency Department Considerations, Reduction of Migraine Triggers

  https://emedicine.medscape.com/article/1142556-treatment

  The goals of preventive therapy are as follows: Reduce attack frequency, severity, and/or duration; Improve responsiveness to acute attacks; Reduce disability. […] Currently, the major prophylactic medications for migraine work via one of the following mechanisms: 5-HT2 antagonism – Methysergide; Regulation of voltage-gated ion channels – Calcium channel blockers; Modulation of central neurotransmitters – Beta blockers, tricyclic antidepressants; Enhancing gamma-aminobutyric acid-ergic (GABAergic) inhibition – Valproic acid, gabapentin; Prevention of acetylcholine from presynaptic membrane Botulinum toxin; Calcitonin gene-related peptide (CGRP) inhibitors Atogepant, eptinezumab, erenumab, fremanezumab, galcanezumab. […] Botulinum toxin A (onabotulinumtoxinA; BOTOX) may be beneficial in patients with intractable, chronic migraine that has failed to respond to at least 3 conventional preventive medications. […] Inhibiting the calcitonin gene-related peptide (CGRP) pathway is a new method to prevent migraines. […] The first CGRP inhibitor approved by the FDA for migraine prophylaxis was erenumab (Aimovig) in May 2018.

• #30

  https://www2.hse.ie/conditions/migraine/treatment-and-prevention/

  If medicine is essential, contact your GP for advice. They may prescribe a low-dose painkiller. In some cases, they may prescribe anti-inflammatory medicine or triptans. […] To reduce your chances of having migraine attacks, you can identify and avoid triggers and take medicines that prevent migraine attacks. […] Your GP may prescribe medicines to prevent attacks if you avoid triggers but you still have migraine attacks, have severe migraine attacks, or have frequent migraine attacks. […] Medicines include topiramate, propranolol, and amitriptyline. […] Topiramate was made to prevent seizures in people with epilepsy. It is now more often used to prevent migraine attacks. […] Propranolol is used to treat angina and high blood pressure. It also prevents migraines. […] Amitriptyline is a medicine to treat depression. But it can also help to prevent migraine attacks. […] These migraine attacks usually happen from 2 days before the start of your period, to 3 days after. […] It may be possible to prevent them with non-steroidal anti-inflammatory medicines (NSAIDs) or triptans.

• #31 Migraine treatment and prevention | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine-treatment-and-prevention/

  Propranolol is a medication used to treat angina and high blood pressure. Its also effective in preventing migraine. […] You might be prescribed tricyclic antidepressants like amitriptyline or nortriptyline. […] Topiramate is a type of medication originally developed to prevent seizures in people with epilepsy. Its now much more commonly used for migraine. […] Other less common options of preventative medications for migraine include: pizotifen, flunarizine. […] There are some complementary therapies and supplements which might help to prevent your migraine symptoms. […] You might be offered advanced therapies for migraine that can only be prescribed by a neurologist. […] If other treatments arent controlling your migraine headaches, you might be referred to a specialist migraine clinic for further treatment.

• #32 Migraine Treatment: A Comprehensive Guide – Southern Pain Society

  https://southernpainsociety.org/migraine-treatment-comprehensive-guide/

  Feverfew, Petadolex (butterbur), and magnesium oxide have all proven effective in double-blind studies as migraine preventives. […] Topiramate is an effective migraine preventive, without the weight gain commonly encountered with the other meds. […] Valproate, or divalproex sodium, (Depakote) is a long-time staple, popular for migraine prevention. […] The -blocker propranolol also is FDA-approved as a preventive agent for migraines. […] Amitriptyline is an effective, inexpensive agent that is useful for the prevention of daily headaches and insomnia. […] Naproxen is a very useful agent for the treatment of daily headaches, as well as for younger women suffering from menstrual migraine. […] There are a number of second-line migraine treatments. […] Polypharmacy is common in migraine prevention.

• #33 Chronic Migraine: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9638-chronic-migraine

  Chronic migraine is more than just having very bad headaches. Treating this condition focuses on reducing the frequency and severity of migraines, making them less disruptive and more treatable. […] Chronic migraine treatments are similar to migraine treatments in general. Medications are the main form of treatment, and there are two main treatment approaches: Preventive: This uses medications to prevent migraines or make them less severe or less frequent. Rescue: These medications rescue you, meaning they shorten migraines and make them less severe. […] Preventive medications are useful for chronic migraine because they make migraines less severe or happen less often. Preventive medications can include: Angiotensin II receptor blockers (ARBs), such as candesartan. Antiseizure medications (such as valproic acid or topiramate). Antidepressants, such as amitriptyline, nortriptyline or venlafaxine. Beta-blockers, such as atenolol, metoprolol or propranolol. Botulinum toxin (Botox) injections. Calcium channel blockers (CCBs), such as verapamil or flunarizine. Monoclonal antibody-based injection treatments, such as erenumab (Aimovig), fremanezumab (Ajovy) or galcanezumab (Emgality).

• #34 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  Non-adherence is also an obstacle to effective treatment and requires management. Education is the solution; clinicians must explain to the patient both the disease and the principles of managing it effectively, including instruction on the correct use of medication, potential adverse effects and what to do about them, and the importance of avoiding medication overuse. […] Multiple effective acute and preventive therapies are available for migraine. When selecting from these therapies, the objective is that each patient receives the therapy that provides the best personal outcome. […] Preventive therapy, in addition, may be indicated at any stage. In general, initiation of preventive therapy is indicated in patients who are adversely affected on 2 days per month despite acute treatment optimized according to the stepped care approach.

• #35 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  There is still an unmet need for more effective, better tolerated prophylactic therapies aimed specifically at patients with CM or high-frequency EM. CGRP and its receptor are well-validated targets for CM, and monoclonal antibodies against CGRP or its receptor are proving very promising for CM prophylaxis in clinical trials. […] Anti-CGRP antibodies are macromolecules that bind to the CGRP ligand or its receptor neutralising the effects of excessive CGRP released in the trigeminal sensory nerve fibres during migraine attacks. Three anti-CGRP/R antibodies are approved in the US and Europe for the prophylactic treatment of CM: fremanezumab and galcanezumab, which target the CGRP ligand; and erenumab, which targets the CGRP receptor. […] The recent introduction of OBT-A and positive phase II and III clinical trial results with anti-CGRP monoclonal antibodies for the prophylactic treatment of CM offers new hope for the many patients with CM who are currently not taking any prophylactic therapy or benefitting from their current treatment. In particular, monoclonal antibodies specifically targeting the CGRP pathway promise a major step forward for the prophylactic treatment of CM.

• #36 VYEPTI® (eptinezumab-jjmr) IV Migraine Prevention Medicine

  https://www.vyepti.com/

  For the preventive treatment of migraine in adults. […] VYEPTI is a prescription medicine used for the preventive treatment of migraine in adults. […] VYEPTI is a prescription medicine used for the preventive treatment of migraine in adults.

• #37 New Treatments for Migraine | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/new-migraine-treatments/

  Anti-CGRP treatments include injections specifically designed to bind to or block CGRP to prevent migraine attacks. […] In addition to oral medications, injections, infusions and nasal sprays, neuromodulation devices can be used to change the way the nerves send information to the brain or adjust how the brain turns on and off the “pain lever.” […] It’s estimated that 40% of patients with migraine will need preventive treatment to reduce the frequency of migraine attacks. […] We’ve made strides in neuromodulation, and Relivion is the newest device currently awaiting approval. […] The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. […] Treatment options vary, from acute treatment to relieve symptoms to preventive treatment to reduce the number of attacks you experience. […] Alternative migraine therapies can work alongside traditional treatments to reduce migraine attack frequency and lessen the impact of symptoms.

• #38 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  To date, OBT-A is the only treatment specifically approved for the prevention of CM in the EU. OBT-A has been shown to be an effective and generally well tolerated treatment for the prevention CM in the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials, and tends to be better tolerated than various oral prophylactic treatments, including topiramate. […] Like OBT-A, topiramate has the highest level of recommendation for the prophylactic treatment of CM in Italian treatment guidelines. Although topiramate reduced headache days versus placebo and was relatively well tolerated in patients with CM in two large randomised controlled trials, adverse events commonly associated with topiramate include paresthesia, memory and concentration disturbances, fatigue and nausea.

• #39 Migraine management

  https://australianprescriber.tg.org.au/articles/migraine-management.html

  Treatments for acute migraine aim to abort the headache stage of migraine within 12 hours. […] As they are more selective against migraine, triptans (5HT1 agonists) may be first-line drugs for patients with moderate-severe pain, or when simple analgesics have not been effective. […] Prophylactic therapy is generally indicated in patients with three or more severe headache days per month causing functional impairment that are not consistently responsive to acute treatments. […] Considerations for choice of preventive medicines include evidence for efficacy, adverse effect profile, drug interactions, contraindications, patient comorbidities, costs, availability and patient preference. […] In Australia, if a patient has chronic migraine but has failed to improve with three oral prophylactic medicines or could not tolerate them, they qualify for Pharmaceutical Benefit Scheme (PBS) subsidised onabotulinum toxin A (Botox) therapy.

• #40 What’s New in Migraine Treatment | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2023/08/whats-new-migraine-treatment

  However, the monoclonal antibodies don’t work for everyone. „These really were the first designer drugs for migraine prevention, says Kathleen Digre, MD, former chief of the Division of Headache and Neuro-Ophthalmology at University of Utah Health. For some people, one of these treatments may be really helpful. However, it’s not going to be always magic”. […] Some of these medications also have side effects that may make them less than attractive to patients. Those can range from constipation to a loss of libido, changes in thinking, or blood pressure issues, according to Digre. Providers need to work closely with patients to make sure the risks don’t outweigh the benefits. […] Gepants are taken orally and are small CGRP molecule blockers. Instead of lasting a full month for prevention, they must be taken every day or every other day to prevent a migraine.

• #41 List of 86 Migraine Medications Compared

  https://www.drugs.com/condition/migraine.html

  There are two main types of medications for migraine attacks: […] Abortive treatments (those that stop a migraine in its tracks) […] Preventive medications (those medications that keep migraines from coming back). […] Acute medications (abortive treatments) for migraine treat a migraine once it has already started. […] Preventive medications may be considered if migraines occur frequently, for example, more than one migraine per week; or if migraine symptoms are severe. […] The goal is to lessen the frequency and severity of the migraine attacks. […] Medication to prevent a migraine is usually taken daily. […] Preventive medications for migraine include: […] CGRP inhibitors used to block the calcitonin gene-related peptide: atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality), and rimegepant (Nurtec ODT — helps treat and prevent migraines). […] The medications listed below are related to or used in the treatment of this condition. […] What is a migraine aura? […] How does Aimovig work to prevent migraines?

• #42 Treat & Help Prevent Migraine | Nurtec® ODT (rimegepant) | Safety Info

  https://www.nurtec.com/why-nurtec

  Only Nurtec ODT can be used to treat or help prevent migraine. […] Treat migraine attacks with one quick-dissolving tablet. […] Help prevent migraine attacks with one quick-dissolving tablet. […] A newer type of migraine treatment. […] Nurtec ODT targets and blocks CGRP (calcitonin gene-related peptide), a protein in the brain believed to be a key cause of migraine attacks. […] Nurtec ODT works by helping block CGRP receptors. […] This prevents CGRP from binding to the receptors, which can help treat and prevent migraine attacks.

• #43 Migraines: Simple steps to head off the pain

  https://www.mayoclinic.org/diseases-conditions/migraine-headache/in-depth/migraines/art-20047242

  Medicine is a proven way to both treat and prevent migraines. […] Combining medicine with behavioral measures and lifestyle can often be the most effective way to handle migraines. […] At the first sign of a migraine, take a break and step away from whatever you’re doing if possible. […] Sip a caffeinated drink. In small amounts, caffeine alone can relieve migraine pain in the early stages. […] Migraines may keep you from falling asleep or wake you up at night. Likewise, migraines are often triggered by a poor night’s sleep. […] Your eating habits can influence your migraines. […] Avoid foods that trigger migraines. If you suspect that a certain food is triggering migraines, remove it from your diet to see what happens. […] During physical activity, your body releases certain chemicals that block pain signals to your brain.

• #44 What’s New in Migraine Treatment | University of Utah Health

  https://healthcare.utah.edu/healthfeed/2023/08/whats-new-migraine-treatment

  CGRP monoclonal antibodies and Gepant preventives are the new kids on the block when it comes to migraine treatment. […] New acute and preventive treatments may be on the way. Migraine specialists like Digre expect other therapies to be coming. […] Aside from medications, new devices also offer help to individuals with migraine. The FDA recently cleared three devices available by prescription. […] „These devices are for people who can’t tolerate medications or who have contraindication to medications,” Digre says. […] Its important that patients not forget basic health advice like staying hydrated, eating a balanced diet, getting enough sleep, exercising regularly, and learning stress reduction techniques. These lifestyle choices can help, Digre says. […] People who suffer from migraine should work with their care provider to determine the correct diagnosis and what treatment is right for them. […] „Migraine is a chronic disease just like diabetes or asthma, Digre says. And like other chronic conditions, educational programs and materials are available for patients. We need patients to help us understand the disease of migraine.”

• #45 Migraine: What It Is, Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches

  A healthcare provider can help you manage symptoms so migraines dont take over your life. […] Treatment is available to help you manage migraines. […] A healthcare provider can help you manage migraine symptoms through the following: Taking medications. Avoiding migraine triggers. Using alternative migraine remedies. […] A healthcare provider might recommend taking medications to treat migraines. […] A healthcare provider usually prescribes preventive medications if you experience severe symptoms that interfere with your routine or have frequent migraines. […] You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best manage your symptoms. […] A healthcare provider can help you identify what triggers your migraines.

• #46 5 Common Alternative Treatments for Migraine | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/common-alternative-treatments-migraine/

  Migraine in the Workplace, Treatment […] Learn about five alternative treatments for migraine and talk to your doctor about which ones may help you manage migraine. Although there is currently no cure for migraine, there are many treatment options available to help you manage symptoms and prepare for attacks. Below we cover five different types of treatment you may want to consider if you live with migraine. These include both acute treatments, which target symptoms after an attack starts, and preventive treatments that work to reduce the number or severity of attacks in the future. […] Magnesium is a nutraceutical—a mineral supplement often used to treat or prevent migraine symptoms. There is some evidence that suggests people with migraine have lower levels of magnesium in the brain compared to those without migraine. In a 2012 study conducted by the American Headache Society and the American Academy of Neurology, researchers determined that magnesium was probably effective and should be considered for patients requiring preventive therapy for migraine.

• #47 Migraine | MedlinePlus

  https://medlineplus.gov/migraine.html

  Certain natural treatments, such as riboflavin (vitamin B2) and coenzyme Q10, may help prevent migraines. […] There is also an herb, butterbur, which some people take to prevent migraines. But butterbur may not be safe for long-term use. Always check with your health care provider before taking any supplements.

• #48 15 home remedies for migraine relief

  https://www.medicalnewstoday.com/articles/322814

  A 2023 review of research on yoga as an add-on therapy for migraine found that yoga can be beneficial in helping people experiencing migraine episodes by reducing their frequency, duration, and pain. […] A 2022 review noted that short-term yoga interventions reduced clinical migraine symptoms. […] A deficiency of the essential mineral magnesium may trigger migraine aura or menstrual migraine headaches. […] A 2022 review of research concluded that supplementary magnesium may help treat migraine, particularly alongside typical antimigraine medications. […] B vitamins may reduce migraine frequency and severity. […] A 2021 review found that vitamin B2 at 400 mg daily for 3 months had a significant effect on the number of days, duration, frequency, and pain score of migraine episodes.

• #49 15 home remedies for migraine relief

  https://www.medicalnewstoday.com/articles/322814

• #50 15 home remedies for migraine relief

  https://www.medicalnewstoday.com/articles/322814

  A 2020 review of herbal treatments for migraine found that curcumin, citron, and coriander may have promise as preventive treatments for migraine. […] According to the American Migraine Foundation, around one-third of people with migraine suggest that dehydration can be a trigger. […] Drinking enough water throughout the day may help prevent migraine episodes from occurring. […] Some people find it helpful to lie down in a dark room when they have a migraine headache. […] Adequate sleep can also help prevent migraine episodes. […] Some people find that laying cool or warm compresses on their heads can be soothing and help reduce migraine pain. […] If an individual experiences migraine symptoms more than a few times per month or if the symptoms are severe enough to interfere with work or other activities, it is important to contact a doctor.

• #51 Migraine Headache Treatment & Management: Approach Considerations, Emergency Department Considerations, Reduction of Migraine Triggers

  https://emedicine.medscape.com/article/1142556-treatment

  A neurologist, neuro-ophthalmologist, and/or neurosurgeon should be consulted as deemed clinically appropriate for the treatment of patients with migraine. […] Emergency medical services personnel should transport patients in a way that minimizes visual and auditory stimulation. […] Migraine-specific medications and analgesia are key elements of ED care. […] Hospital admission for migraine may be indicated for the following: Treatment of severe nausea, vomiting, and subsequent dehydration; Treatment of severe, refractory migraine pain (ie, status migrainosus); Detoxification from overuse of combination analgesics, ergots, or opioids. […] Patients should avoid factors that precipitate a migraine attack (eg, lack of sleep, fatigue, stress, certain foods, use of vasodilators). […] Biofeedback, cognitive-behavioral therapy, and relaxation therapy are frequently effective against migraine headaches and may be used adjunctively with pharmacologic treatments.

• #52 Therapy for Migraine Headaches: Types, Effectiveness, and Access

  https://www.everydayhealth.com/migraine/how-psychotherapy-can-help-with-migraine/

  No, psychotherapy wont cure your migraine. But it can aid you in: Identifying general life stressors, Creating coping skills and strategies for stress, Navigating a full life with a chronic condition like migraine, Better pain management through mindfulness or reprocessing. […] Behavioral therapies can help many people manage migraine pain by changing their thought processes. […] Cognitive Behavioral Therapy (CBT) teaches ways to identify negative thought patterns and shift them in a more positive direction. […] Mindfulness-Based Stress Reduction (MBSR) According to research, this standardized program of small group classes incorporating mindfulness training and yoga can lessen migraine frequency, as well as improve overall quality of life and lessen the disabling quality of chronic pain.

• #53 Migraine sufferers have treatment choices – a neurologist explains options beyond just pain medication

  https://theconversation.com/migraine-sufferers-have-treatment-choices-a-neurologist-explains-options-beyond-just-pain-medication-181348

  Another useful tool is biofeedback, which enables a person to see their vital signs in real time and then learn how to stabilize them. […] Studies show that physical therapy with medication was superior in reducing migraine frequency, pain intensity and pain perception over medications alone. […] Some patients are helped by acupuncture, a form of traditional Chinese medicine. […] Herbal supplements and nutraceuticals, which are food-derived products that may have therapeutic benefit, can also be used to prevent migraine. […] The Food and Drug Administration has approved several neurostimulation devices for migraine treatment. […] These alternative therapies help treat the person as a whole. […] Granted, alternative approaches are not necessarily miracle therapies, but their potential to relieve pain and suffering is notable.

• #54 Latest Research on Migraine Treatments

  https://www.webmd.com/migraines-headaches/migraines-new-treatments

  The latest research has made doctors even more aware of the importance of lifestyle changes in the treatment of migraine. […] The latest research shows that counseling can help with migraines. […] Cognitive behavioral therapy (CBT) is a psychotherapy approach that helps you change thought patterns and behaviors that can make you more tense and may raise your risk for a migraine attack. […] You may find that this helps you manage your migraine pain and the emotions that come with it.

• #55 Therapy for Migraine Headaches: Types, Effectiveness, and Access

  https://www.everydayhealth.com/migraine/how-psychotherapy-can-help-with-migraine/

  Pain Reprocessing Therapy (PRT) uses psychological techniques to retrain the brain to interpret and respond to bodily signals in a way that can help lessen chronic pain. […] Biofeedback uses insights into your bodys stress response as a tool to help you manage migraine pain. […] Relaxation therapies and techniques, like breathing exercises or yoga, can help you manage stress and reduce its power to trigger migraine attacks. […] Therapy is a powerful tool for reducing migraine symptoms and addressing related depression and anxiety. […] Psychotherapy, behavioral therapies like cognitive behavioral therapy (CBT), biofeedback, and mindfulness training can help treat migraine and related mental health issues by addressing the bodys response to stress. […] Therapy and medication can support each other in alleviating migraine symptoms.

• #56 Therapy for migraine: Psychotherapy, other treatments, and more

  https://www.medicalnewstoday.com/articles/therapy-for-migraine

  The American Migraine Foundation notes that people who use CBT, relaxation techniques, or biofeedback therapy have an average of 30-60% fewer headaches following the start of these treatments. […] Psychotherapy may also help people living with depression and anxiety. […] Therapy for migraine may help a person with the severity of their migraine attacks. […] Psychotherapies, such as CBT, may help them to manage stress, anxiety, and depression, which may also help reduce the frequency of migraine attacks. […] In addition to psychotherapy, a person may benefit from taking medications to either treat pain or prevent a migraine headache.

• #57 15 home remedies for migraine relief

  https://www.medicalnewstoday.com/articles/322814

• #58 15 home remedies for migraine relief

  https://www.medicalnewstoday.com/articles/322814

• #59 Treatment options – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1 – ArrowVisualV1

  https://migrainetrust.org/live-with-migraine/healthcare/treatments/

  There are numerous migraine treatment options available […] Acute medicines for migraine are medicines you take when you get a migraine attack, to reduce your symptoms. […] Preventive medicines for migraine are medicines you take to prevent migraine attacks. There are several different types. […] Triptans are medicines that can be used to treat symptoms of a migraine attack. There are several different types. […] Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) are a type of preventive medicine for migraine. […] Gepants are a type of migraine medicine that can be used both to treat and prevent migraine attacks. […] Botox injections are a preventive treatment option for chronic migraine. […] A Greater Occipital Nerve (GON) block is an injection into the back of your head. It can help to prevent migraine attacks. […] Supplements for migraine include riboflavin, magnesium and co-enzyme Q10. […] Acupuncture is a treatment that uses fine needles inserted into the body. It may help some people with preventing migraine attacks. […] Accessing migraine treatment that’s not routinely funded by the NHS.

• #60 Latest Research on Migraine Treatments

  https://www.webmd.com/migraines-headaches/migraines-new-treatments

  Preventive medications, sometimes called prophylactic medications, are designed to stop migraine attacks from starting. […] CGRP monoclonal antibodies like erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) are the latest preventative drug therapies. […] Neuromodulation: These devices deliver electrical current to raise or lessen the activity of your nervous system. […] SPG stimulation: Doctors implant this device through your mouth into the cheekbone, where it remains until they remove it. […] This treatment has been around for about 10 years. […] Doctors inject it in about 31 spots around your head and neck to give relief if you have 15 or more headache days a month (chronic migraine). […] These treatments have also been around for a while, but they continue to evolve.

• #61 Migraine – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/headache/migraine

  The same medications used to prevent episodic migraine, including monoclonal antibodies that block CGRP, are used to treat chronic migraine. Also, supporting evidence is strong for onabotulinumtoxinA and topiramate. […] Neuromodulatory treatments can also help. Transcutaneous supraorbital nerve stimulation, using a device applied to the forehead, can reduce the frequency of migraines.

• #62 Migraine Treatment: A Comprehensive Guide – Southern Pain Society

  https://southernpainsociety.org/migraine-treatment-comprehensive-guide/

  For patients who cannot tolerate triptans, there are a number of other effective non-triptan first-line approaches, including diclofenac potassium powder (Cambia), Excedrin Migraine, naproxen, ketorolac (po/IM/nasal: Sprix nasal spray), ibuprofen, and Prodrin (similar to Midrin, but without the sedative). […] In general, drugs containing ergotamine (also called ergots) are effective second-line therapy for migraines. […] A new therapy has emerged, transcranial magnetic stimulation (TMS). The patient uses a hand-held device applied to the back of the head, for an acute migraine attack. […] Botulinum toxin A (Botox) has been studied extensively in patients with migraines. Nearly 4 million people have had botulinum toxin A injections for headache. Botulinum toxin A has been found to significantly improve quality of life and reduce headache impact. Botox is the only botulinum toxin A FDA-approved for treatment of chronic migraine.

• #63 #1 Prescribed Drug-Free Treatment For Migraine – Nerivio®

  https://www.nerivio.com/

  Safe, effective migraine relief without the risks of systemic side effects. Designed for children, teens, and adults who need a drug-free solution. Nerivio is an FDA-cleared, prescribed, Remote Electrical Neuromodulation (REN) wearable for the prevention and/or treatment of migraine in ages 8 and older. Safe, effective, and easy to use, Nerivio provides consistent migraine relief without systemic side effects that may disrupt your day. Nerivio is the first-and-only Remote Electrical Neuromodulation (REN) wearable that harnesses the natural power of the brain to shut off migraine pain and symptoms without drugs or disruption. Using nerve stimulation initiated from the arm to the brain, Nerivio provides an innovative, non-invasive solution for migraine relief. Nerivio is the only prescribed preventive and dual treatment of migraine for children in this age group (8-11), and the first FDA-cleared, drug-free therapy for acute treatment of migraine in children. Adherence to pharmacological treatments is often low due to disruptive side effects. Nerivio seamlessly integrates into a teen’s daily life at home, school, or on the go providing safe and effective treatment that is easy to follow. Nerivio is drug-free and allows VA patients to control their migraine without medications or disruption. With Nerivio, patients can effectively control their migraine and symptoms, without the common side effects of medications. Studies demonstrate that Nerivio provides safe and consistent migraine relief in the clinical and real-world setting. 7 out of 10 patients achieved pain relief with Nerivio. 9 out of 10 patients demonstrated sustained pain relief and pain freedom at 24 hours. 23% of patients achieved higher relief than with medication. 50% of patients experienced 50% reduction in moderate to severe headache days. Nerivio is the best thing that ever happened to me. It really helps me feel so much better.

• #64 5 Common Alternative Treatments for Migraine | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/common-alternative-treatments-migraine/

  Studies have shown mixed results on the benefits of acupressure and acupuncture in treating migraine. Both are holistic treatments that are sometimes used to reduce pain and stress and prevent migraine attacks. […] Recent research suggests that green light therapy could help reduce the intensity of migraine attacks. This therapy involves exposure to a narrow band of green light from a special lamp. […] A 2019 study in The Journal of Headache and Pain explored the effects of aerobic exercise on migraine frequency and severity. […] Some studies suggest that biofeedback is an effective treatment option for reducing both the frequency and severity of migraine. […] Your doctor may suggest combining more than one treatment option to best manage your symptoms. […] Stay positive and be persistent. With the full range of treatments now available for migraine, you and your doctor have more options than ever to create the right plan to manage your symptoms.

• #65 Migraine Headache Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/1142556-guidelines

  For treating acute migraine attacks in children and adolescents, paracetamol (15 mg/kg, up to 60 mg/kg per day) or ibuprofen (10 mg/kg, up to 30 mg/kg per day) is recommended. If these are ineffective, triptans can be used as second-line therapy in adolescents. […] For women with menstrual migraines, NSAIDs or triptans are recommended as first-line treatments. If these are ineffective, combining triptans with NSAIDs, triptans with antiemetics, or NSAIDs with antiemetics is suggested. […] For pregnant women whose migraine attacks are not controlled by non-pharmacologic methods, paracetamol and triptans can be used cautiously throughout all trimesters.

• #66 Current and emerging evidence-based treatment options in chronic migraine: a narrative review | The Journal of Headache and Pain | Full Text

  https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-019-1038-4

  The first-line treatment of CM is pharmacological. Although there is evidence in support of the use of non-invasive peripheral neurostimulation methods for the prevention of CM, most neurostimulation-based and neuromodulatory treatment techniques need further investigation and should be reserved for the most challenging and intractable cases of CM. Behavioural management techniques (e.g. cognitive therapy, exercise, stress management), alternative physical therapies (e.g. acupuncture) and nutraceutical therapies (e.g. supplementary magnesium, riboflavin and Coenzyme Q10) can all be used to complement pharmacological therapy. […] OnabotulinumtoxinA (OBT-A), which is a formulation of botulinum toxin A administered by intramuscular injection, and topiramate are the only currently available therapies with high-quality evidence for the preventive therapy of CM from more than one randomised controlled trial.

• #67 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  A range of non-pharmacological preventive therapies can be used either as adjuncts to acute and preventive medications or instead of them if medication use is contraindicated. […] Educate patients with migraine about the risk of medication overuse headache with frequent overuse of acute medication. […] Once chronic migraine has developed, its management is challenging and referral to specialist care is usually necessary. If medication overuse headache, which frequently causes symptoms that suggest chronic migraine, can be ruled out, then a preventive treatment should be established. […] Preventive medications for which evidence supports effectiveness in chronic migraine include topiramate, onabotulinumtoxinA and CGRP monoclonal antibodies.

• #68 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  Treatments for migraine include acute and preventive medications and a range of non-pharmacological therapies. Despite these treatment options and the comprehensive diagnostic criteria, clinical care remains suboptimal; misdiagnosis and under-treatment of migraine are substantial public health challenges. […] A comprehensive approach is needed to facilitate accurate diagnosis and evidence-based management. […] In this Consensus Statement, we provide a ten-step approach to the diagnosis and management of migraine. […] The aim of the approach is to support care and clinical decision-making by primary care practitioners, neurologists and headache specialists alike. […] Patient centricity and education have important roles in the management of migraine. Indeed, optimal outcomes are unlikely when these aspects are not given sufficient attention.

• #69 Acute Migraine Headache: Treatment Strategies | AAFP

  https://www.aafp.org/pubs/afp/issues/2025/0400/acute-migraine-headache.html

  Migraine is a primary headache disorder characterized by recurrent disabling attacks. Pharmacologic treatment of acute migraine episodes should be individualized based on route of administration, cost, contraindications, and adverse effects. Stratifying treatment based on migraine severity may result in more rapid resolution of symptoms and return of function. Simple analgesics, such as acetaminophen and nonsteroidal anti-inflammatory drugs, are first-line treatments for mild to moderate migraine episodes, and triptans are first-line therapy for moderate to severe attacks. Antiemetics and ergot alkaloids are recommended as second-line agents and in cases of refractory migraine. Gepants and ditans are promising newer agents that are supported by quality evidence for second-line use. Unlike triptans and ergot alkaloids, gepants and ditans do not have vascular contraindications. The use of these medications is largely limited by cost, although the adverse effects of ditans also may limit their use. Opioids and butalbital-containing medications are not recommended for the treatment of migraine unless other options have been ineffective. There is insufficient evidence to recommend nonpharmacologic therapies, such as neuromodulatory devices, acupuncture, and greater occipital nerve blocks, but these therapies may be appropriate for select patients. […] Migraine is a complex and often disabling disease characterized by episodic attacks that impact activity and productivity.

• #70 Migraine Management | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-treatment

  Because the severity, frequency, and characteristics of migraine vary among patients and, often, within patients over time, and symptom profiles or biomarkers that predict efficacy and AEs for patients have not yet been identified, optimizing treatment for particular patients remains challenging. A process of trial and error is often necessary before a therapeutic plan can be individualized. Additionally, it is important to establish realistic expectations with patients when discussing migraine treatment. […] The success of preventive therapy depends on establishing realistic patient expectations for the given treatment(s). Despite guideline recommendations of a formal, individualized management plan, many patients report not receiving appropriate treatment and follow-up care. […] After initiating a new pharmacologic treatment for migraine or changing an existing treatment, regular follow-up visits are recommended to assess any changes in the frequency and severity of attacks, and to evaluate migraine-related symptoms. To accurately evaluate treatment effectiveness, AHS guidelines recommend that patients be assessed after 3 months (after starting monthly treatments), or 6 months (after starting quarterly treatments).

• #71 Migraine Management | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-treatment

  After at least 3 months of treatment with a mAb targeting the CGRP pathway administered monthly, or after at least 6 months of treatment with mAbs administered quarterly, AHS recommends that the continuation of treatment be contingent on documented benefit of at least 1 of the following: Reduction in mean monthly headache days or headache days of at least moderate severity of 50% relative to the pretreatment baseline, Clinically meaningful improvement in a validated migraine-specific patient-reported outcome measure, including but not limited to HIT-6, MIDAS, MPFID, or other documented benefits reported by clinician and patient.

• #72 Two Studies Examine New Treatment to Prevent Migraine Headaches

  https://www.medstarhealth.org/blog/dysport-migraine-studies

  Two new studies now enrolling participants will examine a new botulinum toxin-based treatment for migraine headaches. […] The studies, E-BEOND and C-BEOND, are Phase III clinical trials testing the safety and effectiveness of Dysport, a form of Botulinum toxin type A, for preventing migraines. […] C-BEOND will examine Dysport for chronic migraine (at least 15 days of headaches, 8 of which were migraines, per month), while E-BEOND focuses on episodic migraine (fewer than 15 headache days per month with at least six days being migraine days). […] Our research could help develop new, effective treatments, and participants will have early access to therapies that could relieve migraine symptoms. […] Dysport is a form of Botulinum toxin type A, a neurotoxin that can cause temporary paralysis. […] If its proven safe and effective, Dysport could become an essential new tool for providers to help patients avoid the burden of migraine attacks. […] These studies of Dysport are an essential step toward that goal.

• #73 Migraine treatments: What are the latest advances? | UCLA Health

  https://www.uclahealth.org/news/publication/migraine-treatments-what-are-latest-advances

  People struggling with migraine may benefit from research over the past decade that has led to impressive advances in treatment. […] This knowledge has led to a new class of medications called anti-CGRP (calcitonin gene-related peptide) drugs, which can be used acutely to treat a migraine attack once it begins, or to prevent migraine attacks from occurring. […] Multiple anti-CGRP drugs are now on the market. Available as intravenous, injection or oral medications, some are aimed at prevention while others are approved to treat acute migraine. […] The CGRP inhibitors may be just the beginning. […] Medication as well as non-medication therapies are offered at the UCLA Goldberg Migraine Program. […] While more treatment options are now available, many Americans have not been properly diagnosed or dont know that there are newer, more effective medications.

• #74 Migraine Overview and Summary of Current and Emerging Treatment Options

  https://www.ajmc.com/view/migraine-overview-and-summary–of-current-and-emerging-treatment-options

  The new migraine preventive agents already approved may find a place in therapy by possessing more favorable safety and tolerability profiles. The emerging migraine agents yet to be approved may also fall into the category of more favorable safety and tolerability profiles, based on the mechanisms of action each agent is targeting. […] With the approval of 3 new medications and 4 others in the pipeline, this is an exciting time for individuals with migraines and healthcare providers. The first class of migraine medications since the 1990s has emerged and may make an impact on individuals who currently experience migraines.

• #75 Migraine Management | Science of Migraine

  https://www.scienceofmigraine.com/management/migraine-treatment

  Preventive treatments pharmacologic, interventional, biobehavioral, neurostimulation, nutraceuticals, and lifestyle modification are important parts of the overall approach for a proportion of people with migraine, and multiple evidence-based guidelines are available. Preventive treatment is recommended for patients with elevated headache frequency, increased symptom severity, and/or impaired functioning. […] Preventive pharmacologic treatments should be considered for patients with migraine in any of the following situations: Attacks significantly interfere with patients daily routines despite acute treatment, Frequent attacks (4 MHDs), Contraindication to, failure, or overuse of acute treatment, Adverse events with acute treatment, Patient preference. […] The 2021 AHS position statement for integrating new migraine therapies into clinical practice included both existing and recently approved therapies. The statement recommended that patients with migraine should be considered for preventive treatment in any of the circumstances listed above. Some of the goals of preventive therapy include reducing migraine attack frequency, duration, and/or severity.

• #76 Migraine | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/migraine

  NINDS supports new and innovative research to better understand, diagnose, and treat many pain conditions, including migraine. […] The goal of these studies is to improve treatment, quality of life, and wellbeing for people living with migraine. […] Scientists funded by NINDS are identifying and testing new medicines and other treatment options. […] NINDS also created and revised common data elements (CDE) guidelines for headache to make research studies on headache and migraine more effective, efficient, and standardized. […] Clinical trials increase our understanding of migraine with the goal of improving how doctors treat it.

Zobacz więcej