Migraine prophylaxis-all just antibodies? Medical and nonmedical migraine preventive treatment in times of CGRP antibodies

Background Migraine is a frequently underdiagnosed disease that is associated with a high burden on affected patients. There are a variety of prophylactic treatment options available, that have been expanded with the introduction of the CGRP-(receptor-)antibodies. Objectives Status of pharmacologic and nonpharmacologic preventive treatment in migraine therapy. Methods Analysis and evaluation of internationally published articles concerning preventive treatment of episodic and chronic migraine. Results There are many approved medications for migraine prophylaxis with different evidence. The possibilities were further expanded with CGRP antibodies. Comparative studies of the new antibodies with previous prophylactic drugs have not yet been published, so it's unclear whether the antibodies are therapeutically superior. What should be emphasized is their rapid onset of action and their good tolerance. Basically, an individual choice of prophylaxis, which is based on affectedness, comorbidities and comedication, makes sense. In addition, a combination with nondrug measures is always mandatory. Conclusions A variety of medicinal and non-medicinal measures are available for the treatment of migraine, which should be used multimodally.