New drugs, treatments, studies and clinical guidelines, summarised in plain language with a link to the original source.
Clinical guidelines
Clinical practice guideline recommendations for the pharmacological treatment of migraine prevention in adults: Report of the AAN Guideline Subcommittee and the American Headache Society
This publication presents an update to the clinical practice guidelines based on a systematic review of studies until June 2024 in the United States. The multidisciplinary panel offers structured recommendations on when to start preventive treatment and how to choose the most suitable drug according to the patient profile. It includes specific guidelines for people with fibromyalgia, obesity, hypertension, older adults, and situations of pregnancy or breastfeeding. For the patient, this means more personalized care and clear criteria regarding efficacy, side effects, and when to stop the medication.
Migraine is added to the NHS England Pharmacy First program
NHS England announced the inclusion of low-frequency episodic migraine in its Pharmacy First program for autumn 2026. This initiative allows patients in England to receive assessment, advice, and prescription treatments directly at community pharmacies without a prior appointment with a GP. The change aims to reduce the treatment gap, as 29% of patients could not get a medical appointment when they needed it. For the patient, this means faster, closer, and more convenient access to professional care and necessary referrals.
Migraine prevention changes in 2026: it is no longer necessary to wait for it to become chronic
The new AAN and AHS guidelines for 2026 propose starting preventive treatment in earlier stages, without waiting for migraine to become chronic. It is recommended to act when the patient suffers 4 or more attack days per month or presents significant disability. The change allows access to traditional drugs (topiramate, propranolol) and new treatments against CGRP (atogepant, monoclonal antibodies) based on daily impact, improving quality of life and personalizing therapy according to each profile.
The Canadian Drug Agency recommends reimbursement of UBRELVY® (ubrogepant) for the treatment of migraine attacks
The Canadian Drug Agency has issued a positive recommendation for the public reimbursement of UBRELVY (ubrogepant), an oral CGRP antagonist drug for adults with migraine with or without aura. The decision is based on phase III studies that demonstrated efficacy in the suppression and relief of pain and associated symptoms. This advancement in Canada expands specific therapeutic options for attacks, allowing for greater treatment personalization and improving access for patients with moderate to high intensity headaches.
This technical article from the University of Duisburg-Essen analyzes the management of medication-overuse headache (MOH) and prophylaxis in children. In adults with MOH, studies with erenumab (70/140 mg) and eptinezumab (100 mg) showed remissions of up to 69% and 40% respectively. For the pediatric population, a new study with fremanezumab is highlighted, which reduced episodic migraine days. These findings offer patients new effective therapeutic alternatives, such as monoclonal antibodies, compared to conventional treatments and the placebo effect.
Migraine management in children and adolescents: a systematic review of practice guidelines and recommendations
This systematic review analyzed 8 international clinical guidelines (such as AAN and NICE) published in the last decade regarding pediatric migraine. The results confirm the consensus on using paracetamol and ibuprofen as first-line treatment, and nasal sumatriptan or zolmitriptan as the second option. However, there is variability in doses and preventive treatments, with a lack of information identified regarding anti-CGRP drugs and neuromodulation. For the patient, this means that, while there are clear guidelines for rapid relief, prevention still needs to be better standardized.
The Spanish Society of Neurology launches its new Clinical Practice Manual on Headaches
The Spanish Society of Neurology (SEN) has published the fifth edition of its reference manual for healthcare professionals in Spain. This update incorporates the latest advances in monoclonal antibodies, gepants and biological therapies against migraine, which affects 14% of the population. For the patient, this ensures an approach based on the most recent scientific evidence, including new non-pharmacological strategies, digital tools and interventional techniques to improve diagnosis and quality of life in neurology and primary care consultations.
Gepants, ditans and monoclonal antibodies: the roadmap for Spanish Neurology to integrate the new therapeutic era in headaches
The Spanish Society of Neurology has published its fifth clinical guideline on headaches, which updates the treatment for more than five million patients in Spain. The document highlights the efficacy of monoclonal antibodies and the new gepants and ditans, which improve functional capacity and offset economic costs within three months. Despite the advances, the guide denounces access barriers in the public system. The patient will benefit from care that now integrates surgery, digital health, and exercise recommendations for the first time.
2025 Guideline Update for the Acute Treatment of Migraine in Adults in the Emergency Department: Evidence Evaluation of Parenteral Pharmacotherapies from the American Headache Society
This systematic review and meta-analysis from the American Headache Society updates the recommendations for the treatment of migraine in the emergency department for adults after evaluating 26 new clinical trials. It concludes that treatment with IV prochlorperazine and greater occipital nerve blocks should be offered as a priority due to their high efficacy. Conversely, the use of IV hydromorphone is strongly discouraged and IV paracetamol is questioned. For the patient, this ensures more effective management of acute pain through validated injectable therapies, avoiding ineffective drugs.
Acupuncture recommendations for migraine in headache treatment guidelines: a systematic review
This systematic review evaluated 25 global guidelines on the use of acupuncture for migraine. The results show that, although 40% recommend its use, the methodological quality is low and 77.8% lack details about the procedure. Only 4% of the guidelines offer high-quality recommendations. For the patient, this means that, although acupuncture is a recognized option, the lack of clear standards in current medical guidelines makes precise and uniform clinical application difficult.
Closing the gap between evidence and clinical practice for migraines: a systematic review (2019-2024)
This systematic review analyzed 169 randomized clinical trials on migraine published between 2019 and 2024 worldwide to evaluate their clinical usefulness. The results show that, although 50.9% exceed the average usefulness and 98.8% are patient-centered, less than 2% are considered of high usefulness. Serious deficiencies persist in data transparency (1.8%) and economic evaluations (0.6%). For the patient, this means that current research does not yet fully translate into practical, equitable, and accessible improvements for their daily treatment.
International Headache Society evidence-based clinical practice guideline on the use of non-invasive neuromodulation devices for the acute and preventive treatment of migraine
This International Headache Society guideline reviewed 15 clinical studies to evaluate non-invasive neuromodulation devices. Weak recommendations were issued for the acute use of SAVI Dual, Cefaly, Relivion, and Nerivio, and for the preventive use of gammaCore Sapphire, Cefaly, and Nerivio. For the patient, these devices represent a safe, well-tolerated alternative without drug interactions compared to traditional drugs, although the quality of current evidence varies from very low to moderate due to small sample sizes.