Acute Migraine Treatment

Jessica Ailani, MD, FAHS, FAAN Headache p. 597-612 June 2021, Vol.27, No.3 doi: 10.1212/CON.0000000000000956
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PURPOSE OF REVIEW Migraine is a disabling disease of attacks of moderate to severe pain with associated symptoms. Every person with migraine requires treatment for acute attacks. Treatments can range from behavioral management and nonspecific medications to migraine-specific medications and neuromodulation. For many with migraine, having a combination of tools allows for effective treatment of all types of attacks.

RECENT FINDINGS Over the past several years, four neuromodulation devices have been cleared by the US Food and Drug Administration (FDA) for treatment of acute migraine, and three medications with novel mechanisms of action have been FDA approved. They add to the arsenal available to people with migraine and focus on migraine-specific pathways to allow for precise care with fewer side effects.

SUMMARY This article discusses acute migraine therapy, focusing on best-level evidence.

Address correspondence to Dr Jessica Ailani, 3800 Reservoir Rd NW, 7PHC, Department of Neurology, Washington DC, 20007, [email protected].

RELATIONSHIP DISCLOSURE: Dr Ailani serves as a section editor for Current Pain and Headache Reports, as a section editor and on the migraine steering committee for Medscape, as an editor for NeurologyLive, and as medical editor for SELF magazine. Dr Ailani has served as a consultant for Allergan/AbbVie Inc; Amgen Inc; Axsome Therapeutics, Inc; Biohaven Pharmaceuticals; Impel NeuroPharma, Inc; Lilly; Satsuma Pharmaceuticals, Inc; Teva Pharmaceutical Industries Ltd; Theranica Bio-Electronics Ltd; Vorso Corporation; and Zosano Pharma Corporation. Dr Ailani has received personal compensation for speaking engagements for Allergan/AbbVie Inc, Amgen Inc, Biohaven Pharmaceuticals, Lilly, and Teva Pharmaceutical Industries Ltd and has received research/grant support from Allergan/AbbVie Inc; Biohaven Pharmaceuticals; Lilly; Satsuma Pharmaceuticals, Inc; and Zosano Pharma Corporation.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Ailani reports no disclosure.

© 2021 American Academy of Neurology.