Migraine meds
Pro Research Analysisby 
Searched over 200M research papers for "migraine meds"
Migraine Medications: An Overview of Acute and Preventive Treatments
Acute Migraine Treatment: Triptans and NSAIDs
Triptans for Acute Migraine Relief
Triptans are a cornerstone in the acute treatment of migraine attacks. Medications such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, and zolmitriptan have been shown to be highly effective in providing relief from migraine symptoms. These drugs work by targeting serotonin receptors, which helps to reduce inflammation and constrict blood vessels, thereby alleviating headache pain1 9. Sumatriptan is available in various forms, including oral, nasal spray, injectable, and transcutaneous patch, offering flexibility in administration based on patient preference and severity of symptoms1.
NSAIDs and Combination Therapies
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, diclofenac, and naproxen are also effective in treating acute migraine attacks. These medications help reduce inflammation and pain. Combination therapies, such as sumatriptan/naproxen and acetaminophen/aspirin/caffeine, have shown to be particularly effective, providing enhanced relief by targeting multiple pathways involved in migraine pathophysiology1 8 9.
Preventive Migraine Treatment: Antiepileptic Drugs and Beta-Blockers
Valproate and Topiramate
For patients experiencing frequent and severe migraine attacks, preventive treatment is often necessary. Valproate (valproic acid or sodium valproate) and topiramate are two antiepileptic drugs that have been extensively studied and are recommended for migraine prophylaxis. Valproate has been shown to significantly reduce headache frequency and is generally well-tolerated, making it a suitable first-line option for many patients2 5. Topiramate has also demonstrated efficacy in reducing the frequency of migraine attacks and is considered a first-line preventive treatment5.
Beta-Blockers and Other Preventive Agents
Beta-blockers such as propranolol and metoprolol are commonly used for migraine prevention. These medications help to stabilize blood vessels and reduce the frequency and severity of migraine attacks. Other preventive agents include flunarizine, amitriptyline, and naproxen, which have varying degrees of efficacy and are often considered when first-line treatments are not suitable or effective10.
Emerging Treatments and Natural Products
New Pharmacological Agents
Recent advancements in migraine treatment have introduced new pharmacological agents such as galcanezumab, erenumab, and ubrogepant. These medications target specific pathways involved in migraine pathogenesis and have shown promising results in reducing migraine frequency and severity3. Additionally, lasmiditan, a serotonin receptor agonist, has been effective in providing acute relief from migraine pain3.
Natural Products and Their Potential
Natural products and their semi-synthetic forms are gaining attention for their potential in migraine treatment. Compounds such as ginkgolide B, melatonin, and petasin have shown promise in preliminary studies. These agents may offer alternative options for patients seeking treatments with fewer side effects4.
Conclusion
Migraine management requires a multifaceted approach, combining acute and preventive treatments tailored to individual patient needs. Triptans and NSAIDs remain the mainstay for acute migraine relief, while antiepileptic drugs and beta-blockers are effective for prevention. Emerging treatments and natural products offer new hope for patients, highlighting the importance of ongoing research in this field. Clinicians must consider the efficacy, side effects, and patient preferences when prescribing migraine medications to optimize treatment outcomes.
Sources and full results
Most relevant research papers on this topic
The Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies
Many acute migraine treatments have evidence supporting their efficacy, including triptans, dihydroergotamine, and various nonspecific medications.
Systematic Review
Rigorous Journal
Highly CitedValproate (valproic acid or sodium valproate or a combination of the two) for the prophylaxis of episodic migraine in adults.
Valproate effectively reduces migraine headache frequency in adults with episodic migraine, with divalproex sodium showing the most promise for preventing migraine attacks.
Systematic Review
Very Rigorous JournalHighly CitedEfficacy of Different Drugs for Migraine Treatment
Dexketoprofen, galcanenzuma, Erenumab, TV-48125, Gapant, and losmiditan show promising results in reducing migraine pain and reducing agony days.
Natural products and their (semi-)synthetic forms in treatment of migraine: History and current status.
Natural products show promise as potential antimigraine drugs, with potential for better efficacy and fewer adverse-effects.
Systematic ReviewRole of Antiepileptic Drugs as Preventive Agents for Migraine
Valproate and topiramate are effective and well-tolerated in migraine prevention, while acetazolamide, lamotrigine, oxcarbazepine, and vigabatrin show no evidence of effectiveness.
Systematic ReviewAntiepileptics other than gabapentin, pregabalin, topiramate, and valproate for the prophylaxis of episodic migraine in adults.
Antiepileptic drugs other than gabapentin, pregabalin, topiramate, and valproate show limited efficacy in preventing migraine attacks in adult patients with episodic migraine.
Systematic ReviewVery Rigorous JournalMigraine Treatment: Current Acute Medications and Their Potential Mechanisms of Action
Acute migraine medications aim to rapidly restore function with minimal recurrence and avoid side effects, with individualized treatment choices based on attack characteristics, patient preferences, and drug properties.
Very Rigorous JournalHighly CitedIbuprofen with or without an antiemetic for acute migraine headaches in adults.
Ibuprofen effectively reduces acute migraine headache symptoms and is well-tolerated by adults, with higher doses providing better relief.
Meta-AnalysisVery Rigorous JournalHighly CitedAcute Migraine Treatment in Adults
Acetaminophen, NSAIDs, and triptans are effective acute migraine treatments, but individualized treatment plans are needed based on patient features and contraindications.
Literature ReviewRigorous JournalHighly CitedEFNS guideline on the drug treatment of migraine – report of an EFNS task force
The EFNS guideline recommends oral NSAIDs and triptans for acute migraine treatment, with intravenous acetylsalicylic acid for severe attacks, and betablockers for migraine prophylaxis.
Systematic ReviewHighly Cited