Brain & Nervous System Migraines Treatment Migraine Treatments on the Horizon New knowledge about the biology behind migraine attacks means improved therapies By Colleen Doherty, MD Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Updated on June 29, 2021 Medically reviewed by Huma Sheikh, MD Medically reviewed by Huma Sheikh, MD Facebook LinkedIn Twitter Huma Sheikh, MD, is a board-certified neurologist, specializing in migraine and stroke, and affiliated with Mount Sinai of New York. Learn about our Medical Expert Board Print When it comes to treating migraines, major advancements have been made in recent years. Traditionally, migraine treatments consisted of medications approved for other conditions, but now there are drugs specifically indicated to treat and prevent multiple forms of migraine. If you experience recurrent migraines, you can rest easy knowing there are several newer options to choose from and that scientific evidence about treating this condition continues to evolve. EmirMemedovski / Getty Images Novel Anti-Migraine Medications A number of migraine medications that work in novel ways are being developed, and some have been approved by the Food and Drug Administration (FDA). Trying these medications may be a good option for you if you have not experienced relief or if you have had side effects with other migraine medicines. Reyvow Reyvow (lasmiditan) was approved by the FDA in late 2019 for treating acute migraine attacks. Although this medication works by targeting the hormone serotonin just like the mainstay migraine treatments, such as triptans and dihydroergotamines, it does not induce vasoconstriction (blood vessel constriction). This difference means Reyvow is safer for people who have certain heart conditions, including a history of heart disease, stroke, peripheral vascular disease, or uncontrolled high blood pressure. Calcitonin Gene-Related Peptide (cGRP) Blockers Calcitonin gene-related peptide (cGRP) is a protein that affects pain, inflammation, and blood vessel activity. During a migraine attack, cGRP is released from trigeminal nerve endings, triggering inflammation. The FDA has approved several medications that regulate cGRP in the body: cGRP antagonists, which are used to prevent migraines, and cGRP inhibitors, which are used to treat in-progress (acute) migraines. One of these drugs, Nurtec ODT (rimegepant), has been approved to both treat and prevent migraines. Nurtec ODT is the first and only medication approved for both purposes. An Overview of cGRP Inhibitors PACAP38 Receptor Blockers A relatively new approach to migraine treatment involves targeting the pituitary adenylate cyclase-activating peptide-38 (PACAP38) receptor. This peptide is believed to induce migraines, possibly through a mechanism of vasodilation (widening of the blood vessels) in the brain as well as inflammation. Current animal and human studies evaluating the possibility of targeting the PACAP38 receptor for migraine therapy are underway. Devices for Migraine Therapy Several devices have been approved by the FDA for migraine treatment. These options use external electrical stimulation to prevent or treat migraines. There is some evidence that disruption of electrical activity in the brain may be an early event in a migraine. The idea behind these devices is that they may alleviate altered electrical activity, preventing or reducing the symptoms of a migraine. Cefaly A device called Cefaly targeting the supraorbital nerve, which mediates pain sensation in part of the forehead, scalp, and upper eyelid, is approved to treat patients with migraine with and without aura. This battery-operated device is worn like a headband and can be used during an acute migraine attack or daily for migraine prevention. Nerivio Nerivio is the first FDA-approved, smartphone-controlled, prescription wearable device for acute migraine treatment of episodic or chronic migraine with or without aura. Nerivio is a wearable device that deploys remote electrical neuromodulation (REN). It works by stimulating small nerves in the upper arm. The message from the arm is transmitted up to a pain regulation center in the brainstem. This process results in pain relief that can end the migraine attack. Nerivio is a band worn on the upper arm, and users can increase the intensity of the treatment with an accompanying smartphone app. GammaCore This non-invasive vagus nerve stimulation (nVNS) device can be used to treat acute migraine attacks. It is held against the side of the neck for approximately two minutes after applying a conductive gel, and it works by stimulating the vagus nerve. Spring Transcranial Magnetic Stimulator (sTMS) A third device called the Spring transcranial magnetic stimulator (sTMS) is FDA-approved for treating migraine with aura. You use this by applying the device to the back of your head and pressing a button, which releases stimulating magnetic energy into the brain. It is believed to work by suppressing cortical spreading depression, a wave of electrical activity that sweeps across the brain during a migraine. Neurostimulation Devices for Migraines A Word From Verywell As you manage your migraines over the years, you may find a lifestyle and medication regimen that works for you. However, if you are not experiencing relief of your symptoms, or if you have side effects, then it may be worth trying new and emerging treatment options. You may even consider talking with your healthcare provider about the possibility of participating in a clinical trial. Migraine Doctor Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Reyvow (lasmiditan). Full Prescribing Information. Last revised January 2021. Iyengar S, Johnson KW, Ossipov MH, Aurora SK. CGRP and the Trigeminal System in Migraine. Headache. 2019 May;59(5):659-681. doi: 10.1111/head.13529. Nurtec ODT (rimegepant). Full Prescribing Information. Last revised May 2021. Vollesen ALH, Ashina M. Pacap38: emerging drug target in migraine and cluster headache. Headache: The Journal of Head and Face Pain. 2017 May;57(2):56-63. doi:10.1111/head.13076 Riederer F, Penning S, Schoenen J. Transcutaneous Supraorbital Nerve Stimulation (t-SNS) with the Cefaly® Device for Migraine Prevention: A Review of the Available Data. Pain Ther. 2015 Oct 14;4(2):135–47. doi: 10.1007/s40122-015-0039-5. Yarnitsky D, Dodick DW, Grosberg BM, et al. Remote electrical neuromodulation (REN) relieves acute migraine: A randomized, double-blind, placebo-controlled, multicenter trial. Headache. 2019 Sep;59(8):1240-1252. doi:10.1111/head.13551. Tassorelli C, Grazzi L, de Tommaso M, et al. Noninvasive vagus nerve stimulation as acute therapy for migraine: The randomized PRESTO study. Neurology. 2018 Jul 24;91(4):e364-e373. doi: 10.1212/WNL.0000000000005857. Lan L, Zhang X, Li X, Rong X, Peng Y. The efficacy of transcranial magnetic stimulation on migraine: a meta-analysis of randomized controlled trials. J Headache Pain. 2017;18(1):86. doi:10.1186/s10194-017-0792-4. By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit