Drugs for Migraine Prophylaxis
Abstract
BACKGROUND
Frequent or severe migraine attacks are an indication for drug and nondrug prophylaxis.
METHODS
In this narrative review, we summarize the guideline of the International Headache Society concerning the treatment and prophylaxis of migraine with drugs, with additional consideration of meta-analyses on monoclonal antibodies and gepants.
RESULTS
In episodic migraine with an average of 8 migraine or headache days/month at baseline, oral prophylactic drugs lowered the number of migraine days per month by 1.27 (beta-blockers), 0.44 (flunarizine), 1.2 (amitriptyline), and 1.4 (topiramate) compared to placebo. Monoclonal antibodies against calcitonin gene-related peptide (CGRP) or the CGRP receptor are effective against both episodic and chronic migraine: Eptinezumab lowered the number of migraine days per month by 0.7-3.2, fremanezumab by 1.3-3.8, galcanezumab by 1.1-3.7, and erenumab by 1.0-2.5. High-level evidence also supports the efficacy of the CGRP receptor antagonist atogepant (0.7-2.4 fewer migraine days per month) in both episodic and chronic migraine. The monoclonal antibodies, atogepant, and onabotulinum toxin A are well-tolerated and have been found effective even in patients for whom previous oral migraine prophylactic drugs were ineffective, as well as in chronic migraine both with and without acute drug overuse.
CONCLUSION
The new prophylactic drugs against migraine are effective, well-tolerated, and especially useful for patients for whom traditional oral…
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.