Emerging drugs for migraine treatment

INTRODUCTION: Migraine is a highly prevalent and disabling neurological condition whose personal, social and economic impact is substantial. Abortive and preventative treatments of this condition are still unsatisfactory, with poor control of the acute symptoms of the single attacks in many cases and a frequent progression towards chronicity. AREAS COVERED: The major drug classes recently developed and/or in current development for migraine treatment are discussed. These include: Calcitonin-Gene-Related Peptide (CGRP) receptor antagonists, mAbs against CGRP or its receptor, selective 5 hydroxytryptamine (5-HT)1F receptor agonists, drugs targeting Acid-Sensing Ion Channels, Transient Receptor Potential channels and Nitric Oxide. EXPERT OPINION: The most convincing results appear those obtained with mAbs against CGRP, particularly in migraine preventative treatment, given the absence of serious adverse events, and the good response in terms of pain relief. If these results are confirmed in larger studies, these compounds have the potential to significantly improve the pharmacological control of migraine and also its evolution towards chronicity.