Current and investigational drugs for the prevention of migraine in adults and children.

There are only a handful of drugs that have been submitted for and received an indication for the preventative treatment of migraine by the US Food and Drug Administration, as well as international governmental regulatory agencies. However, there are a wide variety of agents that are used for this indication with different levels of evidence for efficacy and tolerability. Several guidelines have been published in recent years examining the evidence-based medicine of migraine preventative therapy and these provide guidance especially for the primary care clinician, but also for neurologists whose primary focus is not headache medicine. Some of the therapies are used in children and adolescents while others are used more commonly in adults. In the adult population, an evolutive state of migraine is more commonly seen than in young persons, that is chronic migraine. There is a paucity of evidence for medications for this stage of migraine but there is a single agent that is approved for this use but not for use in the treatment of episodic migraine. There have been few advances in the field of migraine-preventative medications in recent years but potential novel approaches are in development.