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<p>Migraine management has undergone a&#xa0;fundamental transformation in recent years. While nonspecific analgesics and triptans were the mainstay of acute treatment for decades, new substances such as gepants and ditans now allow for targeted therapy without vasoconstrictive risks. In prophylaxis, monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway have significantly improved the quality of life for many patients. The current S1&#xa0;guideline (as of 2025) integrates these innovations and defines clear escalation steps. This article highlights the evidence base, practical application, and management of patient groups who are inadequately controlled under classic therapies or present contraindications. With the introduction of oral gepants, the boundaries between acute therapy and prophylaxis are becoming increasingly blurred, opening up entirely new treatment strategies.</p>

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Neue Medikamente in Akuttherapie und Prophylaxe der Migräne – Ein Update für die Praxis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月26日

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  • Marie Hartenau

摘要

Migraine management has undergone a fundamental transformation in recent years. While nonspecific analgesics and triptans were the mainstay of acute treatment for decades, new substances such as gepants and ditans now allow for targeted therapy without vasoconstrictive risks. In prophylaxis, monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway have significantly improved the quality of life for many patients. The current S1 guideline (as of 2025) integrates these innovations and defines clear escalation steps. This article highlights the evidence base, practical application, and management of patient groups who are inadequately controlled under classic therapies or present contraindications. With the introduction of oral gepants, the boundaries between acute therapy and prophylaxis are becoming increasingly blurred, opening up entirely new treatment strategies.