Background: Migraine is one of the most disabling neurological conditions and
associated with high socio-economic costs. Though certain aspects of the pathomechanism of
migraine are still incompletely understood, the leading hypothesis implicates the role of the
activation of the trigeminovascular system. Triptans are considered to be the current gold
standard therapy for migraine attacks; however, their use in clinical practice is limited. Prophylactic
treatment includes non-specific approaches for migraine prevention. All these support
the need for future studies in order to develop innovative anti-migraine drugs.
Objective: The present study is a review of the current literature regarding new therapeutic
lines in migraine research.
Methods: A systematic literature search in the database of PUBMED was conducted concerning
therapeutic strategies in a migraine published until July 2017.
Results: Ongoing clinical trials with 5-HT1F receptor agonists and glutamate receptor antagonists
offer promising new aspects for acute migraine treatment. Monoclonal antibodies against
CGRP and the CGRP receptor are revolutionary in preventive treatment; however, further
long-term studies are needed to test their tolerability. Preclinical studies show positive results
with PACAP- and kynurenic acid-related treatments. Other promising therapeutic strategies
(such as those targeting TRPV1, substance P, NOS, or orexin) have failed to show efficacy in
Conclusion: Due to their side-effects, current therapeutic approaches are not suitable for all
migraine patients. Especially frequent episodic and chronic migraine represents a therapeutic
challenge for researchers. Clinical and preclinical studies are needed to untangle the pathophysiology
of migraine in order to develop new and migraine-specific therapies.