Migraine: integrated approaches to clinical management and emerging treatments

Messoud Ashina, Dawn C. Buse, Håkan Ashina, Patricia Pozo-Rosich, Mario F.P. Peres, Mi Ji Lee, Gisela M. Terwindt, Rashmi Halker Singh, Cristina Tassorelli, Thien Phu Do, Dimos D. Mitsikostas, David W. Dodick

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Migraine is a highly disabling neurological disorder that directly affects more than 1 billion individuals worldwide. Available treatment options differ between countries and include acute, preventive, and non-pharmacological therapies. Because of major progress in the understanding of migraine pathogenesis, novel mechanism-based medications have emerged and expanded the armamentarium of treatments. We provide a comprehensive overview of the current standard of care that will enable informed clinical management. First, we discuss the efficacy, tolerability, and safety profile of various pharmacological therapies for acute and preventive treatment of migraine. Second, we review the current knowledge on non-pharmacological therapies, such as neuromodulation and biobehavioural approaches, which can be used for a multidisciplinary approach to clinical management. Third, we emphasise that any effective treatment strategy starts with building a therapeutic plan tailored to individual clinical characteristics, preferences, and needs. Finally, we explore the outlook of emerging mechanism-based treatments that could address unmet challenges in clinical management of migraine.

Original languageEnglish (US)
Pages (from-to)1505-1518
Number of pages14
JournalThe Lancet
Volume397
Issue number10283
DOIs
StatePublished - Apr 17 2021

ASJC Scopus subject areas

  • Medicine(all)

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