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June 15, 2021

Acute Treatment for Migraine: Contemporary Treatments and Future Directions

Author Affiliations
  • 1Graham Headache Center, Brigham and Women's Hospital Department of Neurology, Harvard Medical School, Boston, Massachusetts
  • 2Department of Neurology, University at Buffalo, State University of New York, Buffalo, New York
JAMA. 2021;325(23):2346-2347. doi:10.1001/jama.2021.7275

Acute treatment for migraine, also called abortive or symptomatic treatment, is used at the time of a migraine attack with the aim of relieving both pain and the associated symptoms of migraine such as photophobia, phonophobia, and nausea. Available data and expert consensus agree that acute treatment should be reliably and quickly effective, have a low incidence of symptom recurrence, be safe and free from bothersome adverse effects that negate the functional benefits of treatment, and be accessible and affordable.1,2 Despite the availability of migraine-specific therapies and nonspecific analgesic acute treatments, these goals can be difficult to meet. In a US population-based study from 2016 involving 8233 participants with episodic migraine, 56% reported inadequate response to acute treatment at 2 hours for at least half of their migraine headaches, and an additional 26% reported recurrence within 24 hours after initial benefit.3