Current Trends in Management of Migraine: A Review of Current Practice and Recent Advances

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 nonpharmacological 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 longterm 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.