Latest Migraine Treatment Landscape

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Key Questions
  • What are the goals of acute versus preventive treatment of migraine?
  • When are preventive treatments warranted for the treatment of migraine?
  • What are some pharmacological and nonpharmacological approaches to preventive migraine care?
  • What are some lifestyle measures that can be useful for managing migraine?
  • Which behavioral therapies are useful for migraine?
  • What are some nutraceuticals that can be useful for migraine prevention?
  • Could migraine “triggers” actually be symptoms of the premonitory phase?
  • What are some pharmacological and nonpharmacological approaches to the acute treatment of migraine?
  • How does an individual know which acute treatment is the right one?
  • How have CGRP inhibitor medications changed the migraine treatment landscape?
Interview Notes
Treatments Mentioned
  • Antiemetics 
  • Atogepant (Qulipta)
  • Butterbur (Petadolex)
  • Candesartan (Atacand)
  • Coenzyme Q10
  • Cognitive behavioral therapy (CBT)
  • Combination analgesics
  • Cyclobenzaprine (Flexeril)
  • Dihydroergotamine (DHE)
  • Eptinezumab (Vyepti)
  • Erenumab (Aimovig)
  • Fremanezumab (Ajovy)
  • Galcanezumab (Emgality)
  • Ketamine
  • Lifestyle factors (sleep, diet, exercise, stress)
  • Lisinopril (Zestril)
  • Magnesium
  • Mindfulness
  • Neuromodulation devices
  • OnabotulinumtoxinA (Botox)
  • Opioids
  • Rimegepant (Nurtec)
  • Topiramate (Topamax)
  • Tricyclic antidepressants
  • Triptans
  • Ubrogepant (Ubrelvy)
  • Valproate (Depakote)
  • Venlafaxine (Effexor)
  • Vitamin B2 (riboflavin)

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Deborah Friedman, MD, MPH, FAAN, FAHS

Neuro-Ophthalmologist & Headache Specialist
Dallas, TX

Dr. Deborah Friedman is a neurologist specializing in headache medicine and neuro-ophthalmology in Dallas. She was the founding director of the Headache and Facial Pain Program and Cerebrospinal Fluid Dynamics Program at the University of Texas Southwestern Medical Center. She is board certified in neurology and headache medicine, and is a Fellow of the American Academy of Neurology, the American Headache Society (AHS), the American Neurological Association, and the North American Neuro-Ophthalmology Society (NANOS).

She served on the board of directors for the AHS and the Southern Headache Society, as a past president of NANOS, and on the steering committee for the Idiopathic Intracranial Hypertension Treatment Trial. She has published over 130 articles in peer-reviewed journals and 27 book chapters. Her key interests are intracranial pressure disorders, migraine, and cluster headache.

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