Migraine affects about 1 in 7 people worldwide and is the second-leading cause of disability globally. Treatment includes pills for acute attacks, preventive medications taken daily, and newer anti-CGRP drugs that have transformed prevention for many people. Research now focuses on understanding migraine's root causes and developing treatments that work faster and for more people.
What's actually going on in research
Trials are testing oral CGRP antagonists that work within an hour for acute attacks, monthly or quarterly injectable preventives, nerve stimulation devices, and drugs that target different migraine pathways like PACAP and orexin. Studies are also investigating why some people respond to one treatment but not another, and whether treating migraine early can prevent chronic daily headache.
CGRP antagonists
Pills like rimegepant and zavegepant work quickly to stop attacks and can also prevent future migraines when taken regularly. Injectable anti-CGRP antibodies like erenumab, approved since 2018, cut monthly migraine days in half for many people.
Device therapies
Non-invasive nerve stimulators worn on the head, arm, or neck offer drug-free options. Several are FDA-cleared for acute treatment or prevention, and new trials are testing devices that predict and abort attacks before pain starts.
Novel pathways
PACAP-blocking drugs target a signaling molecule involved in migraine. Orexin antagonists, already used for sleep, are being tested for chronic migraine since orexin affects pain and wakefulness.
What to know before you search
Eligibility typically depends on migraine frequency, prior treatments tried, whether headaches are episodic or chronic, and presence of aura.
What types of trials are currently open
- Acute treatment trials — Testing medications or devices taken at the start of a migraine to stop pain and other symptoms within hours.
- Prevention trials — Testing daily pills, monthly injections, or devices to reduce the number of migraine days per month.
- Chronic migraine trials — Studies for people with headaches on 15 or more days per month, testing treatments to reduce frequency and disability.
- Device trials — Testing nerve stimulation or other non-drug approaches for acute relief or prevention.
- Observational studies — Following people with migraine over time to identify triggers, track treatment response, and understand who develops chronic migraine.
Recently added Migraine trials
Receive an intravenous infusion of magnesium for emergency headache relief
Headache is one of the most common reasons for consultation in emergency departments and represents a significant cause of disability, particularly in patients with migraine and other primary headache disorders. Despite the availability of several analgesic treatments, including nonsteroidal anti-inflammatory drugs and paracetamol, pain relief is often incomplete, and a proportion of patients require additional rescue therapy. Magnesium sulfate has emerged as a potential therapeutic option in acute headache due to its role in modulating neuronal excitability, vascular tone, and pain-related neurotransmitter release. However, its efficacy as a standalone treatment, the optimal intravenous dose, and its comparative effectiveness versus standard therapy remain unclear. This randomized, double-blind, controlled trial aims to evaluate the efficacy and safety of intravenous magnesium sulfate in the treatment of acute non-traumatic headache in the emergency department. Participants will be randomly assigned to receive either low-dose magnesium sulfate (2 g IV), high-dose magnesium sulfate (4 g IV), or intravenous paracetamol (1 g IV) as an active comparator. The primary outcome is the change in pain intensity measured using the Visual Analog Scale (VAS) at 60 minutes after treatment administration, as well as the proportion of patients achieving at least 50% pain reduction. Secondary outcomes include time course of pain relief, need for rescue medication, adverse events, patient satisfaction, and length of stay in the emergency department. In addition, the study will assess baseline ionized magnesium levels to explore their relationship with treatment response and evaluate whether magnesium levels may predict clinical efficacy. The results of this study may help clarify the role of intravenous magnesium sulfate in the management of acute headache and potentially improve treatment strategies in emergency settings.
Take an inhaled medication being tested for migraine prevention
Migraine is a debilitating neurological disorder characterized by recurrent headaches episodes, often accompanied by amplified perception of multiple sensory inputs such as cutaneous allodynia, photophobia, and phonophobia. The suggested mechanism in migraine is likely through sensitized trigeminovascular and dysfunctional pain modulatory systems. Dexmedetomidine, a selective α2-adrenergic receptor agonist, exerts central antinociceptive effects by reducing neuronal hyperexcitability, glial activation, and CGRP expression. Nebulized administration provides a non-invasive alternative to intravenous use, with rapid CNS absorption and minimal sedation .
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