Scoping Review of Prophylactic Treatments for Reducing Migraine Occurrences
Abstract
Background:
Migraine is a prevalent neurological disorder with significant socioeconomic and quality-of-life burdens. While acute treatments exist, prophylactic therapies are essential to reducing monthly migraine days (MMDs). This scoping review evaluates pharmacologic, non-pharmacologic, and procedural interventions for migraine prevention, with an emphasis on osteopathic manipulative treatment (OMT), supplements, and emerging therapies.
Methods:
A comprehensive literature search was conducted across PubMed, ClinicalTrials.gov, Cochrane Library, OSTMED.Dr, Still OneSearch, CINAHL, ClinicalKey, and Scopus using standardized keywords. Grey literature sources, including major headache organizations, were also reviewed. Studies were included if they examined prophylactic migraine treatments and reported changes in MMDs.
Results:
Among pharmacologic interventions, onabotulinumtoxinA (Botox) and CGRP inhibitors demonstrated the greatest reductions in MMDs. Non-pharmacologic approaches, including OMT, acupuncture, and neuromodulation, showed varying effectiveness, often as adjunct therapies. Nutraceuticals, such as magnesium and riboflavin, provided modest benefits. Variability in study design, patient populations, and outcome measures impacted direct comparisons.
Conclusion:
A range of prophylactic treatments exist for reducing MMDs, with efficacy varying by patient population. While pharmacologic options remain primary, non-pharmacologic and procedural therapies offer promising…
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