Updated Recommendations Address Medications to Prevent Migraine in Adults

WEDNESDAY, Sept. 2, 2026 (HealthDay News) — Updated recommendations are presented to help clinicians decide which medications may be effective for preventing migraine in adults in two reports issued by the American Academy of Neurology and American Headache Society and published online Aug. 31 in Neurology.

In a research article, Tamara Pringsheim, M.D., from the University of Calgary in Alberta, Canada, and colleagues conducted a systematic review to inform updated evidence-based recommendations regarding the use of pharmacologic migraine prevention in adults. Overall, 217 studies met the inclusion criteria. The researchers found that based on high-confidence evidence, galcanezumab and erenumab were more effective than placebo for reducing headache frequency in episodic migraine. High-confidence evidence supported reductions in headache frequency with fremanezumab, galcanezumab, and onabotulinumtoxinA for chronic migraine. Improvements were seen in patient-reported quality-of-life outcomes with erenumab, fremanezumab, galcanezumab, eptinezumab, rimegepant, atogepant, topiramate, and onabotulinumtoxinA across episodic and chronic migraine populations.

In a special article, Sonja Potrebic, M.D., from Southern California Permanente Medical Group in Los Angeles, and colleagues provide updated evidence-based recommendations relating to the use of pharmacological migraine prevention in adults. Recommendations are provided on how to decide when it is appropriate to start a pharmacologic migraine preventive medication and address decision-making related to appropriate choices of migraine preventive medications in specific situations and populations.

“For people experiencing frequent migraine attacks or attacks that affect the ability to function normally, this guideline can help clinicians determine which preventive medications may be able to help,” Pringsheim said in a statement.

Several authors from both articles disclosed ties to the biopharmaceutical and publishing industries; several authors received payment as expert witnesses.

Abstract/Full Text – Research Article

Abstract/Full Text – Special Article (subscription or payment may be required)