Skip to content
2000
image of Current Trends in Management of Migraine: A Review of Current Practice and Recent Advances

Abstract

Introduction

Migraine is a common and debilitating neurological condition marked by recurring headaches and sensory disturbances. Although it poses a significant global health burden, its long-term management remains a challenge. Advances in pathophysiological insights have facilitated the development of more targeted treatment approaches. This review explores current and emerging strategies, including diagnostic methods, risk factors, and both pharmacological and non-pharmacological interventions.

Methods

An extensive literature review was conducted to evaluate both conventional and emerging treatment strategies for migraine. The analysis focused on the various phases of migraine, associated therapeutic options, underlying pathophysiological pathways, and existing treatment gaps. A comparative assessment of mechanisms of action, safety profiles, and treatment limitations was also conducted to identify current challenges and research needs.

Results

The literature highlights recent advances in both acute and preventive treatments for migraine. Key developments include the increasing use of CGRP antagonists (gepants), monoclonal antibodies, and non-invasive neuromodulation techniques. In addition, several FDA-approved drugs such as amitriptyline, ergotamine, flunarizine, and sumatriptan remain widely used. Novel agents, including topiramate, amiloride, and candesartan, are also being evaluated in clinical trials for their potential in migraine management.

Discussions

While conventional therapies like triptans, NSAIDs, and lifestyle interventions continue to serve as foundational treatments, the shift toward more personalized and mechanism-based approaches is evident. The integration of targeted therapies and neuromodulation reflects growing recognition of migraine’s complex pathophysiology. Personalized care models and the exploration of newer pharmacological agents offer promising avenues for more effective and sustainable long-term management.

Conclusion

A variety of effective treatments are available for migraine, with choice dependent on severity, frequency, comorbidities, and individual tolerance. Gepants, Triptans, and Nutraceuticals represent a promising advancement in migraine therapy due to their targeted action and improved safety. Personalized treatment approaches are essential for optimal management outcomes.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cnsnddt/10.2174/0118715273408295250825074429
2025-09-11
2025-12-14

  • From This Site

    /content/journals/cnsnddt/10.2174/0118715273408295250825074429
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Dodick D.W. Migraine. Lancet 2018 391 10127 1315 1330 10.1016/S0140‑6736(18)30478‑1 29523342
    [Google Scholar]
  2. Xu X.M. Yang C. Liu Y. Dong M.X. Zou D.Z. Wei Y.D. Efficacy and feasibility of antidepressants for the prevention of migraine in adults: A meta‐analysis. Eur J Neurol 2017 24 8 1022 1031 10.1111/ene.13320 28557171
    [Google Scholar]
  3. Pescador Ruschel M.A. De Jesus O. Migraine Headache. StatPearls Treasure Island, FL StatPearls Publishing 2025
    [Google Scholar]
  4. Gupta J. Gaurkar S.S. Migraine: An underestimated neurological condition affecting billions. Cureus 2022 14 8 e28347 10.7759/cureus.28347 36168353
    [Google Scholar]
  5. Ashina M. Katsarava Z. Do T.P. Buse D.C. Pozo-Rosich P. Özge A. Krymchantowski A.V. Lebedeva E.R. Ravishankar K. Yu S. Sacco S. Ashina S. Younis S. Steiner T.J. Lipton R.B. Migraine: Epidemiology and systems of care. Lancet 2021 397 10283 1485 1495 10.1016/S0140‑6736(20)32160‑7 33773613
    [Google Scholar]
  6. Coppola G. Di Lorenzo C. Parisi V. Lisicki M. Serrao M. Pierelli F. Clinical neurophysiology of migraine with aura. J Headache Pain 2019 20 1 42 10.1186/s10194‑019‑0997‑9 31035929
    [Google Scholar]
  7. Olesen J. International classification of headache disorders. Lancet Neurol 2018 17 5 396 397 10.1016/S1474‑4422(18)30085‑1 29550365
    [Google Scholar]
  8. Hansen J.M. Lipton R.B. Dodick D.W. Silberstein S.D. Saper J.R. Aurora S.K. Goadsby P.J. Charles A. Migraine headache is present in the aura phase. Neurology 2012 79 20 2044 2049 10.1212/WNL.0b013e3182749eed 23115208
    [Google Scholar]
  9. Konstantinos S. Vikelis M. Rapoport A. Acute care and treatment of migraine. J Neuroophthalmol 2020 40 4 472 484 10.1097/WNO.0000000000001053 32956223
    [Google Scholar]
  10. Silvestro M. Orologio I. Siciliano M. Trojsi F. Tessitore A. Tedeschi G. Russo A. Emerging drugs for the preventive treatment of migraine: A review of CGRP monoclonal antibodies and gepants trials. Expert Opin Emerg Drugs 2023 28 2 79 96 10.1080/14728214.2023.2207819 37185047
    [Google Scholar]
  11. de Boer I. Verhagen I.E. Souza M.N.P. Ashina M. Place of next generation acute migraine specific treatments among triptans, non-responders and contraindications to triptans and possible combination therapies. Cephalalgia 2023 43 2 10.1177/03331024221143773 36739516
    [Google Scholar]
  12. Hutchinson S. Dodick D.W. Treppendahl C. Bennett N.L. Yu S.Y. Guo H. Trugman J.M. Ubrogepant for the acute treatment of migraine: Pooled efficacy, safety, and tolerability from the achieve i and achieve ii phase 3 randomized trials. Neurol Ther 2021 10 1 235 249 10.1007/s40120‑021‑00234‑7 33608814
    [Google Scholar]
  13. Peters G.L. Migraine overview and summary of current and emerging treatment options. Am J Manag Care 2019 25 2 S23 S34 30681821
    [Google Scholar]
  14. Puledda F. Sacco S. Diener H.C. Ashina M. Al-Khazali H.M. Ashina S. Burstein R. Liebler E. Cipriani A. Chu M.K. Cocores A. Dodd-Glover F. Ekizoğlu E. Garcia-Azorin D. Göbel C. Goicochea M.T. Hassan A. Hirata K. Hoffmann J. Jenkins B. Kamm K. Lee M.J. Ling Y.H. Lisicki M. Martinelli D. Monteith T.S. Ornello R. Ozge A. Peres M. Pozo-Rosich P. Romanenko V. Schwedt T.J. Souza M.N.P. Takizawa T. Terwindt G.M. Thuraiaiyah J. Togha M. Vandenbussche N. Wang S.J. Yu S. Tassorelli C. International Headache Society global practice recommendations for the acute pharmacological treatment of migraine. Cephalalgia 2024 44 8 03331024241252666 10.1177/03331024241252666 39133176
    [Google Scholar]
  15. Charles A. Advances in the basic and clinical science of migraine. Ann Neurol 2009 65 5 491 498 10.1002/ana.21691 19479724
    [Google Scholar]
  16. Gazerani P. The neuroplastic brain: Current breakthroughs and emerging frontiers. Brain Res 2025 1858 149643 10.1016/j.brainres.2025.149643 40280532
    [Google Scholar]
  17. Gasparini C.F. Smith R.A. Griffiths L.R. Genetic and biochemical changes of the serotonergic system in migraine pathobiology. J Headache Pain 2017 18 1 20 10.1186/s10194‑016‑0711‑0 28194570
    [Google Scholar]
  18. Andreou A.P. Edvinsson L. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain 2019 20 1 117 10.1186/s10194‑019‑1066‑0 31870279
    [Google Scholar]
  19. Giffin N.J. Ruggiero L. Lipton R.B. Silberstein S.D. Tvedskov J.F. Olesen J. Altman J. Goadsby P.J. Macrae A. Premonitory symptoms in migraine. Neurology 2003 60 6 935 940 10.1212/01.WNL.0000052998.58526.A9 12654956
    [Google Scholar]
  20. Durbin R.P. Letter: Acid secretion by gastric mucous membrane. Am J Physiol 1975 229 6 1726 10.1152/ajplegacy.1975.229.6.1726 2020
    [Google Scholar]
  21. Maniyar F.H. Sprenger T. Monteith T. Schankin C. Goadsby P.J. Brain activations in the premonitory phase of nitroglycerin-triggered migraine attacks. Brain 2014 137 1 232 241 10.1093/brain/awt320 24277718
    [Google Scholar]
  22. Charles A. Migraine. Curr Opin Neurol 2013 26 3 235 239 10.1097/WCO.0b013e32836085f4 23493160
    [Google Scholar]
  23. Costa C. Tozzi A. Rainero I. Cupini L.M. Calabresi P. Ayata C. Sarchielli P. Cortical spreading depression as a target for anti-migraine agents. J Headache Pain 2013 14 1 62 10.1186/1129‑2377‑14‑62 23879550
    [Google Scholar]
  24. Lauritzen M. Dreier J.P. Fabricius M. Hartings J.A. Graf R. Strong A.J. Clinical relevance of cortical spreading depression in neurological disorders: Migraine, malignant stroke, subarachnoid and intracranial hemorrhage, and traumatic brain injury. J Cereb Blood Flow Metab 2011 31 1 17 35 10.1038/jcbfm.2010.191 21045864
    [Google Scholar]
  25. Oshinsky M.L. Luo J. Neurochemistry of trigeminal activation in an animal model of migraine. Headache 2006 46 s1 S39 S44 10.1111/j.1526‑4610.2006.00489.x 16927963
    [Google Scholar]
  26. Eftekhari S. Edvinsson L. Possible sites of action of the new calcitonin gene-related peptide receptor antagonists. Ther Adv Neurol Disord 2010 3 6 369 378 10.1177/1756285610388343 21179597
    [Google Scholar]
  27. Goadsby P.J. Holland P.R. Martins-Oliveira M. Hoffmann J. Schankin C. Akerman S. Pathophysiology of migraine: A disorder of sensory processing. Physiol Rev 2017 97 2 553 622 10.1152/physrev.00034.2015 28179394
    [Google Scholar]
  28. Dodick D.W. A phase‐by‐phase review of migraine pathophysiology. Headache 2018 58 S1 4 16 10.1111/head.13300 29697154
    [Google Scholar]
  29. Khan J. Asoom L.I.A. Sunni A.A. Rafique N. Latif R. Saif S.A. Almandil N.B. Almohazey D. AbdulAzeez S. Borgio J.F. Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine. Biomed Pharmacother 2021 139 111557 10.1016/j.biopha.2021.111557 34243621
    [Google Scholar]
  30. Pavlovic J.M. Buse D.C. Sollars C.M. Haut S. Lipton R.B. Trigger factors and premonitory features of migraine attacks: Summary of studies. Headache 2014 54 10 1670 1679 10.1111/head.12468 25399858
    [Google Scholar]
  31. The international classification of headache disorders, 3rd edition. Cephalalgia 2018 38 1 1 211 10.1177/0333102417738202 29368949 Headache Classification Committee of the International Headache Society (IHS)
    [Google Scholar]
  32. Russell M.B. Olesen J. Increased familial risk and evidence of genetic factor in migraine. BMJ 1995 311 7004 541 544 10.1136/bmj.311.7004.541 7663209
    [Google Scholar]
  33. Palmirotta R. Barbanti P. Ludovici G. De Marchis M.L. Ialongo C. Egeo G. Aurilia C. Fofi L. Abete P. Spila A. Ferroni P. Della-Morte D. Guadagni F. Association between migraine and ACE gene (insertion/deletion) polymorphism: The BioBIM study. Pharmacogenomics 2014 15 2 147 155 10.2217/pgs.13.186 24444405
    [Google Scholar]
  34. Ophoff R.A. Terwindt G.M. Vergouwe M.N. van Eijk R. Oefner P.J. Hoffman S.M.G. Lamerdin J.E. Mohrenweiser H.W. Bulman D.E. Ferrari M. Haan J. Lindhout D. van Ommen G.J.B. Hofker M.H. Ferrari M.D. Frants R.R. Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4. Cell 1996 87 3 543 552 10.1016/S0092‑8674(00)81373‑2 8898206
    [Google Scholar]
  35. Fusco M.D. Marconi R. Silvestri L. Atorino L. Rampoldi L. Morgante L. Ballabio A. Aridon P. Casari G. Haploinsufficiency of ATP1A2 encoding the Na+/K+ pump α2 subunit associated with familial hemiplegic migraine type 2. Nat Genet 2003 33 2 192 196 10.1038/ng1081 12539047
    [Google Scholar]
  36. Dichgans M. Freilinger T. Eckstein G. Babini E. Lorenz-Depiereux B. Biskup S. Ferrari M.D. Herzog J. van den Maagdenberg A.M.J.M. Pusch M. Strom T.M. Mutation in the neuronal voltage-gated sodium channel SCN1A in familial hemiplegic migraine. Lancet 2005 366 9483 371 377 10.1016/S0140‑6736(05)66786‑4 16054936
    [Google Scholar]
  37. Riant F. Roze E. Barbance C. Méneret A. Guyant-Maréchal L. Lucas C. Sabouraud P. Trébuchon A. Depienne C. Tournier-Lasserve E. PRRT2 mutations cause hemiplegic migraine. Neurology 2012 79 21 2122 2124 10.1212/WNL.0b013e3182752cb8 23077016
    [Google Scholar]
  38. Friedrich T. Tavraz N.N. Junghans C. ATP1A2 mutations in migraine: Seeing through the facets of an ion pump onto the neurobiology of disease. Front Physiol 2016 7 239 10.3389/fphys.2016.00239 27445835
    [Google Scholar]
  39. Grangeon L. Lange K.S. Waliszewska-Prosół M. Onan D. Marschollek K. Wiels W. Mikulenka P. Farham F. Gollion C. Ducros A. Genetics of migraine: Where are we now? J Headache Pain 2023 24 1 12 10.1186/s10194‑023‑01547‑8 36800925
    [Google Scholar]
  40. Bertelli S. Barbieri R. Pusch M. Gavazzo P. Gain of function of sporadic/familial hemiplegic migraine-causing SCN1A mutations: Use of an optimized cDNA. Cephalalgia 2019 39 4 477 488 10.1177/0333102418788336 29986598
    [Google Scholar]
  41. Stubberud A. O’Connor E. Tronvik E. Houlden H. Matharu M. R1352Q CACNA1A Variant in a patient with sporadic hemiplegic migraine, ataxia, seizures and cerebral oedema: A case report. Case Rep Neurol 2021 13 1 123 130 10.1159/000512275 33790770
    [Google Scholar]
  42. Weatherall M.W. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis 2015 6 3 115 123 10.1177/2040622315579627 25954496
    [Google Scholar]
  43. Schwedt T.J. Dodick D.W. Advanced neuroimaging of migraine. Lancet Neurol 2009 8 6 560 568 10.1016/S1474‑4422(09)70107‑3 19446275
    [Google Scholar]
  44. Cala L.A. Mastaglia F.L. Computerized axial tomography in the detection of brain damage. 2. Epilepsy, migraine, and general medical disorders. Med J Aust 1980 2 11 616 620 10.5694/j.1326‑5377.1980.tb77065.x 7464620
    [Google Scholar]
  45. Orhanbulucu F. Latifoğlu F. Baydemir R. A new hybrid approach based on time frequency images and deep learning methods for diagnosis of migraine disease and investigation of stimulus effect. Diagnostics 2023 13 11 1887 10.3390/diagnostics13111887 37296739
    [Google Scholar]
  46. Abdalla K. Alawneh K.Z. Al-Bdour M. Abu-Salih A.Q. Migraine and MRI: Uncovering potential associations. Head Face Med 2025 21 1 6 10.1186/s13005‑024‑00478‑2 39955604
    [Google Scholar]
  47. Wang H.Z. Simonson T.M. Greco W.R. Yuh W.T.C. Brain M.R. Brain MR imaging in the evaluation of chronic headache in patients without other neurologic symptoms. Acad Radiol 2001 8 5 405 408 10.1016/S1076‑6332(03)80548‑2 11345271
    [Google Scholar]
  48. Mullally W.J. Hall K.E. Value of patient-directed brain magnetic resonance imaging scan with a diagnosis of migraine. Am J Med 2018 131 4 438 441 10.1016/j.amjmed.2017.10.042 29146234
    [Google Scholar]
  49. Qin Z. He X.W. Zhang J. Xu S. Li G.F. Su J. Shi Y.H. Ban S. Hu Y. Liu Y.S. Zhuang M.T. Zhao R. Shen X.L. Li J. Liu J.R. Du X. Altered spontaneous activity and functional connectivity in the posterior pons of patients with migraine without aura. J Pain 2020 21 3-4 347 354 10.1016/j.jpain.2019.08.001 31400473
    [Google Scholar]
  50. Filippi M. Messina R. The chronic migraine brain: What have we learned from neuroimaging? Front Neurol 2020 10 1356 10.3389/fneur.2019.01356 31998217
    [Google Scholar]
  51. Michels L. Koirala N. Groppa S. Luechinger R. Gantenbein A.R. Sandor P.S. Kollias S. Riederer F. Muthuraman M. Structural brain network characteristics in patients with episodic and chronic migraine. J Headache Pain 2021 22 1 8 10.1186/s10194‑021‑01216‑8 33657996
    [Google Scholar]
  52. DeSouza D.D. Woldeamanuel Y.W. Sanjanwala B.M. Bissell D.A. Bishop J.H. Peretz A. Cowan R.P. Altered structural brain network topology in chronic migraine. Brain Struct Funct 2020 225 1 161 172 10.1007/s00429‑019‑01994‑7 31792696
    [Google Scholar]
  53. Juhasz G. Gecse K. Baksa D. Towards precision medicine in migraine: Recent therapeutic advances and potential biomarkers to understand heterogeneity and treatment response. Pharmacol Ther 2023 250 108523 10.1016/j.pharmthera.2023.108523 37657674
    [Google Scholar]
  54. Demartini C. Francavilla M. Zanaboni A.M. Facchetti S. De Icco R. Martinelli D. Allena M. Greco R. Tassorelli C. Biomarkers of migraine: An integrated evaluation of preclinical and clinical findings. Int J Mol Sci 2023 24 6 5334 10.3390/ijms24065334 36982428
    [Google Scholar]
  55. Durham P. Papapetropoulos S. Biomarkers associated with migraine and their potential role in migraine management. Headache 2013 53 8 1262 1277 10.1111/head.12174 23848170
    [Google Scholar]
  56. Paungarttner J. Quartana M. Patti L. Sklenárová B. Farham F. Jiménez I.H. Soylu M.G. Vlad I.M. Tasdelen S. Mateu T. Marsico O. Reina F. Tischler V. Lampl C. Migraine - a borderland disease to epilepsy: Near it but not of it. J Headache Pain 2024 25 1 11 10.1186/s10194‑024‑01719‑0 38273253
    [Google Scholar]
  57. Silberstein S.D. Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review) [RETIRED]. Neurology 2000 55 6 754 762 10.1212/WNL.55.6.754 10993991
    [Google Scholar]
  58. Marmura M.J. Silberstein S.D. Schwedt T.J. The acute treatment of migraine in adults: The american headache society evidence assessment of migraine pharmacotherapies. Headache 2015 55 1 3 20 10.1111/head.12499 25600718
    [Google Scholar]
  59. Derry S. Moore R.A. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. Cochrane Libr 2013 2019 5 CD008040 10.1002/14651858.CD008040.pub3 23633349
    [Google Scholar]
  60. Rabbie R. Derry S. Moore R.A. Ibuprofen with or without an antiemetic for acute migraine headaches in adults. Cochrane Libr 2013 2019 5 CD008039 10.1002/14651858.CD008039.pub3 23633348
    [Google Scholar]
  61. Jóźwiak-Bebenista M. Nowak J.Z. Paracetamol: Mechanism of action, applications and safety concern. Acta Pol Pharm 2014 71 1 11 23 24779190
    [Google Scholar]
  62. Tfelt-Hansen P.C. Delayed absorption of many (paracetamol, aspirin, other NSAIDs and zolmitriptan) but not all (sumatriptan, rizatriptan) drugs during migraine attacks and most likely normal gastric emptying outside attacks. A review. Cephalalgia 2017 37 9 892 901 10.1177/0333102416644745 27330004
    [Google Scholar]
  63. Becker W.J. Acute migraine treatment in adults. Headache 2015 55 6 778 793 10.1111/head.12550 25877672
    [Google Scholar]
  64. Ljubisavljevic M. Ignjatovic A. Djordjevic V. Pesic M.H. Ljubisavljevic S. Depression, anxiety, stress, and health-related quality of life among patients with medication overuse headache in a tertiary headache center: A cross-sectional study. J Neuropsychiatry Clin Neurosci 2021 33 2 132 143 10.1176/appi.neuropsych.20070189 33626886
    [Google Scholar]
  65. Charleston L. Savage-Edwards B. Bragg S.M. Baygani S.K. Dennehy E.B. Migraine history and response to lasmiditan across racial and ethnic groups. Curr Med Res Opin 2022 38 5 721 730 10.1080/03007995.2022.2057152 35350937
    [Google Scholar]
  66. Becker W.J. Acute Migraine Treatment. Continuum (Minneap Minn) 2015 21 4 953 972 10.1212/CON.0000000000000192 26252584
    [Google Scholar]
  67. Razzaque Z. Pickard J.D. Ma Q.P. Shaw D. Morrison K. Wang T. Longmore J. 5‐HT 1B ‐receptors and vascular reactivity in human isolated blood vessels: Assessment of the potential craniovascular selectivity of sumatriptan. Br J Clin Pharmacol 2002 53 3 266 274 10.1046/j.0306‑5251.2001.01536.x 11874390
    [Google Scholar]
  68. Neumann J. Dhein S. Kirchhefer U. Hofmann B. Gergs U. Effects of hallucinogenic drugs on the human heart. Front Pharmacol 2024 15 1334218 10.3389/fphar.2024.1334218 38370480
    [Google Scholar]
  69. Taylor F.R. Kaniecki R.G. Symptomatic treatment of migraine: When to use NSAIDs, triptans, or opiates. Curr Treat Options Neurol 2011 13 1 15 27 10.1007/s11940‑010‑0107‑4 21125432
    [Google Scholar]
  70. Goadsby P.J. Ailani J. Dodick D.W. Starling A.J. Liu C. Liu Y. Yu S.Y. Smith J.H. Brand-Schieber E. Trugman J.M. Ubrogepant for the treatment of migraine prodromal symptoms: An exploratory analysis from the randomized phase 3 PRODROME trial. Nat Med 2025 10.1038/s41591‑025‑03679‑7 40355614
    [Google Scholar]
  71. Li D. Abreu J. Tepper S.J. A Brief Review of Gepants. Curr Pain Headache Rep 2023 27 9 479 488 10.1007/s11916‑023‑01142‑1 37531032
    [Google Scholar]
  72. Rayadurgam J. Sana S. Sasikumar M. Gu Q. Palladium catalyzed C–C and C–N bond forming reactions: An update on the synthesis of pharmaceuticals from 2015–2020. Org Chem Front 2021 8 2 384 414 10.1039/D0QO01146K
    [Google Scholar]
  73. Ahamad S. Branch S. Harrelson S. Hussain M.K. Saquib M. Khan S. Primed for global coronavirus pandemic: Emerging research and clinical outcome. Eur J Med Chem 2021 209 112862 10.1016/j.ejmech.2020.112862 33070079
    [Google Scholar]
  74. Tfelt-Hansen P. Pharmacological strategies to treat attacks of episodic migraine in adults. Expert Opin Pharmacother 2021 22 3 305 316 10.1080/14656566.2020.1828347 33003955
    [Google Scholar]
  75. Smith T.R. Winner P. Aurora S.K. Jeleva M. Hocevar-Trnka J. Shrewsbury S.B. STOP 301: A Phase 3, open‐label study of safety, tolerability, and exploratory efficacy of INP104, Precision Olfactory Delivery (POD ® ) of dihydroergotamine mesylate, over 24/52 weeks in acute treatment of migraine attacks in adult patients. Headache 2021 61 8 1214 1226 10.1111/head.14184 34363701
    [Google Scholar]
  76. Evers S. Áfra J. Frese A. Goadsby P.J. Linde M. May A. Sándor P.S. EFNS guideline on the drug treatment of migraine – revised report of an EFNS task force. Eur J Neurol 2009 16 9 968 981 10.1111/j.1468‑1331.2009.02748.x 19708964
    [Google Scholar]
  77. Martinelli D. Arceri S. Tronconi L. Tassorelli C. Chronic migraine and Botulinum Toxin Type A: Where do paths cross? Toxicon 2020 178 69 76 10.1016/j.toxicon.2020.02.017 32250749
    [Google Scholar]
  78. Tfelt-Hansen P. Prophylactic pharmacotherapy of migraine. Some practical guidelines. Neurol Clin 1997 15 1 153 165 10.1016/S0733‑8619(05)70301‑7 9058403
    [Google Scholar]
  79. Langohr H.D. Gerber W.D. Koletzki E. Mayer K. Schroth G. Clomipramine and metoprolol in migraine prophylaxis--a double-blind crossover study. Headache 1985 25 2 107 112 10.1111/j.1526‑4610.1985.hed2502107.x 3886599
    [Google Scholar]
  80. Hedman C. Andersen A.R. Andersson P.G. Gilhus N.E. Kangasniemi P. Olsson J-E. Strandman E. Nestvold K. Olesen J. Symptoms of classic migraine attacks: Modifications brought about by metoprolol. Cephalalgia 1988 8 4 279 284 10.1046/j.1468‑2982.1988.0804279.x 3064920
    [Google Scholar]
  81. Danesh A. Gottschalk P.C.H. Beta-blockers for migraine prevention: A review article. Curr Treat Options Neurol 2019 21 4 20 10.1007/s11940‑019‑0556‑3 30903383
    [Google Scholar]
  82. Zhang N. Chen C. Yu F. Effects of pregabalin on central sensitization in patients with migraine. Int J Clin Pharmacol Ther 2015 53 4 277 283 10.5414/CP202205 25669613
    [Google Scholar]
  83. Mathew N.T. Rapoport A. Saper J. Magnus L. Klapper J. Ramadan N. Stacey B. Tepper S. Efficacy of gabapentin in migraine prophylaxis. Headache 2001 41 2 119 128 10.1046/j.1526‑4610.2001.111006119.x 11251695
    [Google Scholar]
  84. Schytz H.W. Amin F.M. Jensen R.H. Carlsen L. Maarbjerg S. Lund N. Aegidius K. Thomsen L.L. Bach F.W. Beier D. Johansen H. Hansen J.M. Kasch H. Munksgaard S.B. Poulsen L. Sørensen P.S. Schmidt-Hansen P.T. Cvetkovic V.V. Ashina M. Bendtsen L. Reference programme: Diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020. J Headache Pain 2021 22 1 22 10.1186/s10194‑021‑01228‑4
    [Google Scholar]
  85. Pellesi L. Do T.P. Hougaard A. Pharmacological management of migraine: Current strategies and future directions. Expert Opin Pharmacother 2024 25 6 673 683 10.1080/14656566.2024.2349791 38720629
    [Google Scholar]
  86. Chiang C-C. Schwedt T.J. Calcitonin gene-related peptide (CGRP)-targeted therapies as preventive and acute treatments for migraine—The monoclonal antibodies and gepants. Progress in Brain Research Elsevier 2020 255 143 170 10.1016/bs.pbr.2020.06.019
    [Google Scholar]
  87. Scuteri D. Adornetto A. Rombolà L. Naturale M.D. Morrone L.A. Bagetta G. Tonin P. Corasaniti M.T. New trends in migraine pharmacology: Targeting calcitonin gene–related peptide (CGRP) with monoclonal antibodies. Front Pharmacol 2019 10 363 10.3389/fphar.2019.00363 31024319
    [Google Scholar]
  88. Parua P. Ghosh S. Jana K. Seth A. Debnath B. Rout S.K. Sarangi M.K. Dash R. Halder J. Rajwar T.K. Pradhan D. Rai V.K. Dash P. Das C. Kar B. Ghosh G. Rath G. Therapeutic potential of neutralizing monoclonal antibodies (nmabs) against sars-cov-2 omicron variant. Curr Pharm Des 2025 31 10 753 773 10.2174/0113816128334441241108050528 39543801
    [Google Scholar]
  89. Aditya S. Rattan A. Advances in CGRP monoclonal antibodies as migraine therapy. Saudi J Med Med Sci 2023 11 1 11 18 10.4103/sjmms.sjmms_95_22 36909005
    [Google Scholar]
  90. Gklinos P. Mitsikostas D.D. Galcanezumab in migraine prevention: A systematic review and meta-analysis of randomized controlled trials. Ther Adv Neurol Disord 2020 13 1756286420918088 10.1177/1756286420918088 32426040
    [Google Scholar]
  91. Silberstein S.D. McAllister P. Ning X. Faulhaber N. Lang N. Yeung P. Schiemann J. Aycardi E. Cohen J.M. Janka L. Yang R. Safety and tolerability of fremanezumab for the prevention of migraine: A pooled analysis of phases 2b and 3 clinical trials. Headache 2019 59 6 880 890 10.1111/head.13534 30977520
    [Google Scholar]
  92. Bader Y. Suliman R. Harb M. Santos V. Al Qaisi I. Alsaadi T. Effectiveness and safety of eptinezumab in episodic and chronic migraine headache in the uae: A retrospective study. Neurol Ther 2023 12 5 1683 1693 10.1007/s40120‑023‑00521‑5 37418120
    [Google Scholar]
  93. Pleș H. Florian I.A. Timis T.L. Covache-Busuioc R.A. Glavan L.A. Dumitrascu D.I. Popa A.A. Bordeianu A. Ciurea A.V. Migraine: Advances in the pathogenesis and treatment. Neurol Int 2023 15 3 1052 1105 10.3390/neurolint15030067 37755358
    [Google Scholar]
  94. Worm J. Falkenberg K. Olesen J. Histamine and migraine revisited: Mechanisms and possible drug targets. J Headache Pain 2019 20 1 30 10.1186/s10194‑019‑0984‑1 30909864
    [Google Scholar]
  95. Rasmussen N.B. Deligianni C. Christensen C.E. Karlsson W.K. Al-Khazali H.M. Van de Casteele T. Granhall C. Amin F.M. Ashina M. The effect of Lu AG09222 on PACAP38- and VIP-induced vasodilation, heart rate increase, and headache in healthy subjects: An interventional, randomized, double-blind, parallel-group, placebo-controlled study. J Headache Pain 2023 24 1 60 10.1186/s10194‑023‑01599‑w 37231350
    [Google Scholar]
  96. Ketata I. Ellouz E. Efficacy of nutraceuticals in migraine symptoms relief: A systematic review and network meta-analysis. Adv Integr Med 2025 12 4 100478 10.1016/j.aimed.2025.100478
    [Google Scholar]
  97. Wider B. Pittler M.H. Ernst E. Feverfew for preventing migraine. Cochrane Libr 2015 2020 4 CD002286 10.1002/14651858.CD002286.pub3 25892430
    [Google Scholar]
  98. Fiebich B.L. Grozdeva M. Hess S. Hüll M. Danesch U. Bodensieck A. Bauer R. Petasites hybridus extracts in vitro inhibit COX-2 and PGE2 release by direct interaction with the enzyme and by preventing p42/44 MAP kinase activation in rat primary microglial cells. Planta Med 2005 71 1 12 19 10.1055/s‑2005‑837744 15678367
    [Google Scholar]
  99. Pareek A. Suthar M. Rathore G. Bansal V. Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacogn Rev 2011 5 9 103 110 10.4103/0973‑7847.79105 22096324
    [Google Scholar]
  100. Abo-Elghiet F. Elosaily H. Hussein D.K. El-Shiekh R.A. A’aqoulah A. Yousef E.M. Selim H.M.R.M. El-Dessouki A.M. Bridging gaps in migraine management: A comprehensive review of conventional treatments, natural supplements, complementary therapies, and lifestyle modifications. Pharmaceuticals 2025 18 2 139 10.3390/ph18020139 40005953
    [Google Scholar]
  101. Brune K. Bickel D. Peskar B. Gastro-protective effects by extracts of Petasites hybridus: The role of inhibition of peptido-leukotriene synthesis. Planta Med 1993 59 6 494 496 10.1055/s‑2006‑959746 8302945
    [Google Scholar]
  102. Thomet O.A.R. Wiesmann U.N. Schapowal A. Bizer C. Simon H.U. Role of petasin in the potential anti-inflammatory activity of a plant extract of petasites hybridus11Abbreviations: AA, arachidonic acid; [Ca2+]i, cytosolic free calcium concentration; cPLA2, cytosolic phospholipase A2; C5a, complement factor C5a; FLAP, 5-LO-activating protein; GM-CSF, granulocyte-macrophage colony-stimulating factor; IL, interleukin; IP3, inositol trisphosphate; 5-LO, 5-lipoxygenase; LT, leukotriene; MAPK, mitogen-activated protein kinase; mAb, monoclonal antibody; PAF, platelet-activating factor; and Ze339, CO2 estract of petasites hybridus. Biochem Pharmacol 2001 61 8 1041 1047 10.1016/S0006‑2952(01)00552‑4 11286996
    [Google Scholar]
  103. Wang G.J. Wu X.C. Lin Y.L. Ren J. Shum A.Y.C. Wu Y.Y. Chen C.F. Ca2+ channel blocking effect of iso-S-petasin in rat aortic smooth muscle cells. Eur J Pharmacol 2002 445 3 239 245 10.1016/S0014‑2999(02)01764‑8 12079689
    [Google Scholar]
  104. Borlak J. Diener H.C. Kleeberg-Hartmann J. Messlinger K. Silberstein S. Petasites for migraine prevention: New data on mode of action, pharmacology and safety. a narrative review. Front Neurol 2022 13 864689 10.3389/fneur.2022.864689 35585841
    [Google Scholar]
  105. Tábuas B. Cruz Barros S. Diogo C. Cavaleiro C. Sanches Silva A. Pyrrolizidine alkaloids in foods, herbal drugs, and food supplements: Chemistry, metabolism, toxicological significance, analytical methods, occurrence, and challenges for future. Toxins 2024 16 2 79 10.3390/toxins16020079 38393157
    [Google Scholar]
  106. Agosti R. Duke R.K. Chrubasik J.E. Chrubasik S. Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: A systematic review. Phytomedicine 2006 13 9-10 743 746 10.1016/j.phymed.2006.02.008 16987643
    [Google Scholar]
  107. Ghosh S. Bishal A. Ghosh S.K. Jana K. Gayen B. Sahu S. Debnath B. Herbal medicines: A potent approach to human diseases, their chief compounds, formulations, present status, and future aspects. Int J Membr Sci Technol 2023 10 1 442 464 10.15379/ijmst.v10i1.2608
    [Google Scholar]
  108. Djalali M. Abdolahi M. Hosseini R. Miraghajani M. Mohammadi H. Djalali M. The effects of nano-curcumin supplementation on Th1/Th17 balance in migraine patients: A randomized controlled clinical trial. Complement Ther Clin Pract 2020 41 101256 10.1016/j.ctcp.2020.101256 33147541
    [Google Scholar]
  109. Goschorska M. Gutowska I. Baranowska-Bosiacka I. Barczak K. Chlubek D. The use of antioxidants in the treatment of migraine. Antioxidants 2020 9 2 116 10.3390/antiox9020116 32012936
    [Google Scholar]
  110. Della Pietra A. Krivoshein G. Ivanov K. Giniatullina R. Jyrkkänen H.K. Leinonen V. Lehtonen M. van den Maagdenberg A.M.J.M. Savinainen J. Giniatullin R. Potent dual MAGL/FAAH inhibitor AKU-005 engages endocannabinoids to diminish meningeal nociception implicated in migraine pain. J Headache Pain 2023 24 1 38 10.1186/s10194‑023‑01568‑3 37038131
    [Google Scholar]
  111. Zyrianova T. Lopez B. Zou K. Gu C. Pham D. Talapaneni S. Waters C.M. Olcese R. Schwingshackl A. Activation of TREK-1 ( K 2P 2.1 ) potassium channels protects against influenza A-induced lung injury. Am J Physiol Lung Cell Mol Physiol 2023 324 1 L64 L75 10.1152/ajplung.00116.2022 36410022
    [Google Scholar]
  112. Bala A. Soni D. Sood S. Kumar P. Verma I. Parkash Dora C. Free radicals-induced migraine. Role of Free Radicals in Pathology New York Apple Academic Press 2025 437 455 10.1201/9781003560579‑18
    [Google Scholar]
  113. Parlongue G. Cerdan E.V. Koenig J. Williams D.P. Smartphone based music intervention in the treatment of episodic migraine headaches – A pilot trial. Complement Ther Med 2021 63 102779 10.1016/j.ctim.2021.102779 34601093
    [Google Scholar]
  114. Herrera-Pérez S. Lamas J.A. TREK channels in mechanotransduction: A focus on the cardiovascular system. Front Cardiovasc Med 2023 10 1180242 10.3389/fcvm.2023.1180242 37288256
    [Google Scholar]
  115. Conde R. Corrêa V.S.C. Carmona F. Contini S.H.T. Pereira A.M.S. Chemical composition and therapeutic effects of Lippia alba (Mill.) N. E. Brown leaves hydro-alcoholic extract in patients with migraine. Phytomedicine 2011 18 14 1197 1201 10.1016/j.phymed.2011.06.016 21802924
    [Google Scholar]
  116. Frank D.L. Khorshid L. Kiffer J.F. Moravec C.S. McKee M.G. Biofeedback in medicine: Who, when, why and how? Ment Health Fam Med 2010 7 2 85 91 22477926
    [Google Scholar]
  117. Mullally W.J. Hall K. Goldstein R. Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain Physician 2009 6 12 1005 1011 10.36076/ppj.2009/12/1005 19935987
    [Google Scholar]
  118. Bae J. Sung H.K. Kwon N.Y. Go H.Y. Kim T. Shin S.M. Lee S. Cognitive behavioral therapy for migraine headache: A systematic review and meta-analysis. Medicina 2021 58 1 44 10.3390/medicina58010044 35056352
    [Google Scholar]
  119. Brandell J. Ringel S. Index. Trauma Columbia University Press 2019 387 400 10.7312/ring18886‑016
    [Google Scholar]
  120. Ng Q.X. Venkatanarayanan N. Kumar L. A systematic review and meta‐analysis of the efficacy of cognitive behavioral therapy for the management of pediatric migraine. Headache 2017 57 3 349 362 10.1111/head.13016 28028812
    [Google Scholar]
  121. Singh R.K. Pandey S.K. Singh S. Chittoda A. Chaudhari S.A. Bhatt S. Patil C.R. Mahindroo N. Currently available interventions for the management of migraine pain. Management of Migraine Pain Singapore Springer Nature Singapore 2024 191 227 10.1007/978‑981‑97‑4529‑6_11
    [Google Scholar]
  122. Gavrilov V.I. V.I. Gavrilov. Acta Virol 1975 19 6 510 2003
    [Google Scholar]
  123. Minen M.T. Stieglitz E.J. Sciortino R. Torous J. Privacy issues in smartphone applications: An analysis of headache/migraine applications. Headache 2018 58 7 1014 1027 10.1111/head.13341 29974470
    [Google Scholar]
  124. Hendriks H. Bos R. Woerdenbag H.J. The Essential Oil ofTanacetum parthenium (L.) Schultz-Bip. Flavour Fragrance J 1996 11 6 367 371 10.1002/(SICI)1099‑1026(199611)11:6<367::AID‑FFJ598>3.0.CO;2‑R
    [Google Scholar]
  125. Lampl C. Versijpt J. Amin F.M. Deligianni C.I. Gil-Gouveia R. Jassal T. MaassenVanDenBrink A. Ornello R. Paungarttner J. Sanchez-del-Rio M. Reuter U. Uluduz D. de Vries T. Zeraatkar D. Sacco S. European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention—part 1: Amitriptyline. J Headache Pain 2023 24 1 39 10.1186/s10194‑023‑01573‑6 37038134
    [Google Scholar]
  126. Leone M. Grazzi L. Mantia L.L. Bussone G. Flunarizine in migraine: A minireview. Headache 1991 31 6 388 391 10.1111/j.1526‑4610.1991.hed3106388.x 1889980
    [Google Scholar]
  127. Linde K. Rossnagel K. Propranolol for migraine prophylaxis. Cochrane Database Syst Rev Chichester, UK 2004 CD003225 10.1002/14651858.CD003225.pub2
    [Google Scholar]
  128. Ferrari M.D. Saxena P.R.S. Clinical effects and mechanism of action of sumatriptan in migraine. Clin Neurol Neurosurg 1992 94 73 77 Suppl. 10.1016/0303‑8467(92)90028‑2 1320526
    [Google Scholar]
  129. Obermann M. Naegel Topiramate in the prevention and treatment of migraine: Efficacy, safety and patient preference. Neuropsychiatr Dis Treat 2009 6 17 28 10.2147/NDT.S6459 20169042
    [Google Scholar]
  130. Pascual J. [Mechanism of action of zolmitriptan]. Neurologia 1998 13 9 15 Suppl. 2 9859690
    [Google Scholar]
  131. Karachalios G.N. Fotiadou A. Chrisikos N. Karabetsos A. Kehagioglou K. Treatment of acute migraine attack with diclofenac sodium: A double-blind study. Headache 1992 32 2 98 100 10.1111/j.1526‑4610.1992.hed3202098.x 1551795
    [Google Scholar]
  132. Silberstein S.D. McCrory D.C. Ergotamine and dihydroergotamine: History, pharmacology, and efficacy. Headache 2003 43 2 144 166 10.1046/j.1526‑4610.2003.03034.x 12558771
    [Google Scholar]
  133. Lambert G.A. Preclinical neuropharmacology of naratriptan. CNS Drug Rev 2005 11 3 289 316 10.1111/j.1527‑3458.2005.tb00048.x 16389295
    [Google Scholar]
  134. Sandrini G. Perrotta A. Arce Leal N.L. Buscone S. Nappi G. Almotriptan in the treatment of migraine. Neuropsychiatr Dis Treat 2008 3 6 799 809 10.2147/NDT.S487 19300615
    [Google Scholar]
  135. Capi M. Curto M. Lionetto L. de Andrés F. Gentile G. Negro A. Martelletti P. Eletriptan in the management of acute migraine: An update on the evidence for efficacy, safety, and consistent response. Ther Adv Neurol Disord 2016 9 5 414 423 10.1177/1756285616650619 27582896
    [Google Scholar]
  136. Law S. Derry S. Moore R.A. Naproxen with or without an antiemetic for acute migraine headaches in adults. Cochrane Libr 2013 2013 10 CD009455 10.1002/14651858.CD009455.pub2 24142263
    [Google Scholar]
  137. Andreou A.P. Fuccaro M. Lambru G. The role of erenumab in the treatment of migraine. Ther Adv Neurol Disord 2020 13 1756286420927119 10.1177/1756286420927119 32523630
    [Google Scholar]
  138. Abu-Zaid A. AlBatati S.K. AlHossan A.M. AlMatrody R.A. AlGzi A. Al-Sharief R.A. Alsobyani F.M. Almubarak A.F. Alatiyah N.S. Galcanezumab for the management of migraine: A systematic review and meta-analysis of randomized placebo-controlled trials. Cureus 2020 12 11 e11621 10.7759/cureus.11621 33376635
    [Google Scholar]
  139. Silberstein S.D. Dodick D.W. Bigal M.E. Yeung P.P. Goadsby P.J. Blankenbiller T. Grozinski-Wolff M. Yang R. Ma Y. Aycardi E. Fremanezumab for the preventive treatment of chronic migraine. N Engl J Med 2017 377 22 2113 2122 10.1056/NEJMoa1709038 29171818
    [Google Scholar]
  140. Dighriri I.M. Nazel S. Alharthi A.M. Altowairqi N.A. Albariqi A.M. Tohari M.A. Alameer A.A. Alsaran A.K. ALshammari F.R. AlMutairi N.F. Alsubaie F.M. Alharbi T.A. A comprehensive review of the mechanism, efficacy, safety, and tolerability of ubrogepant in the treatment of migraine. Cureus 2023 15 11 e48160 10.7759/cureus.48160 38046695
    [Google Scholar]
  141. Clemow D.B. Johnson K.W. Hochstetler H.M. Ossipov M.H. Hake A.M. Blumenfeld A.M. Lasmiditan mechanism of action – review of a selective 5-HT1F agonist. J Headache Pain 2020 21 1 71 10.1186/s10194‑020‑01132‑3 32522164
    [Google Scholar]
  142. Blair H.A. Rimegepant: A review in the acute treatment and preventive treatment of migraine. CNS Drugs 2023 37 3 255 265 10.1007/s40263‑023‑00988‑8 36739335
    [Google Scholar]
  143. Datta A. Maryala S. John R. A review of eptinezumab use in migraine. Cureus 2021 13 9 e18032 10.7759/cureus.18032 34540516
    [Google Scholar]
  144. Boinpally R. Shebley M. Trugman J.M. Atogepant: Mechanism of action, clinical and translational science. Clin Transl Sci 2024 17 1 e13707 10.1111/cts.13707 38266063
    [Google Scholar]
  145. Zobdeh F. ben Kraiem A. Attwood M.M. Chubarev V.N. Tarasov V.V. Schiöth H.B. Mwinyi J. Pharmacological treatment of migraine: Drug classes, mechanisms of action, clinical trials and new treatments. Br J Pharmacol 2021 178 23 4588 4607 10.1111/bph.15657 34379793
    [Google Scholar]
  146. Lampl C. MaassenVanDenBrink A. Deligianni C.I. Gil-Gouveia R. Jassal T. Sanchez-del-Rio M. Reuter U. Uluduz D. Versijpt J. Zeraatkar D. Sacco S. The comparative effectiveness of migraine preventive drugs: A systematic review and network meta-analysis. J Headache Pain 2023 24 1 56 10.1186/s10194‑023‑01594‑1 37208596
    [Google Scholar]
  147. Ziegeler C. Brauns G. Jürgens T.P. May A. Shortcomings and missed potentials in the management of migraine patients - experiences from a specialized tertiary care center. J Headache Pain 2019 20 1 86 10.1186/s10194‑019‑1034‑8 31370788
    [Google Scholar]
  148. Russo A.F. Hay D.L. CGRP physiology, pharmacology, and therapeutic targets: Migraine and beyond. Physiol Rev 2023 103 2 1565 1644 10.1152/physrev.00059.2021 36454715
    [Google Scholar]
  149. Borsook D. Maleki N. Becerra L. McEwen B. Understanding migraine through the lens of maladaptive stress responses: A model disease of allostatic load. Neuron 2012 73 2 219 234 10.1016/j.neuron.2012.01.001 22284178
    [Google Scholar]
  150. Alsaadi T. Al Madani A. Alhatou M. Nada M. Albilali A. Al-Qassabi A. Mohamed H. Mohamed H. El Masry R. Saifuddin G.A. AlRukn S.A. Prevalence, Treatment, and Unmet Needs of Migraine in the Middle East: A Systematic Review. Pain Ther 2025 14 1 145 183 10.1007/s40122‑024‑00686‑3 39738973
    [Google Scholar]
  151. Li Y. Ji R.R. Gene therapy for chronic pain management. Cell Rep Med 2024 5 10 101756 10.1016/j.xcrm.2024.101756 39366385
    [Google Scholar]
  152. Torrente A. Maccora S. Prinzi F. Alonge P. Pilati L. Lupica A. Di Stefano V. Camarda C. Vitabile S. Brighina F. The clinical relevance of artificial intelligence in migraine. Brain Sci 2024 14 1 85 10.3390/brainsci14010085 38248300
    [Google Scholar]
/content/journals/cnsnddt/10.2174/0118715273408295250825074429
Loading
Current Trends in Management of Migraine: A Review of Current Practice and Recent Advances
Bentham Science Publishers ; https://doi.org/10.2174/0118715273408295250825074429
/content/journals/cnsnddt/10.2174/0118715273408295250825074429
/content/journals/cnsnddt/10.2174/0118715273408295250825074429
Loading

Data & Media loading...


  • Article Type:     Review Article
Keywords: Migraine ; diagnosis ; pathogenesis ; management ; novel treatment ; genetics

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test