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This document published by the International Headache Society provides practical recommendations for the preventive pharmacological treatment of migraines. The recommendations are categorized into two levels: Optimal and Essential, based on medication availability in different regions. The document includes a table listing drugs with evidence of efficacy for migraine prevention and their availability in the World Health Organization Model List of Essential Medicines. The recommendations aim to establish essential standards of migraine management worldwide and provide guidance on evaluating treatment effectiveness, switching medications, combination therapy, and duration of treatment. The document also discusses comorbidities, specific medications for chronic migraine, preventive treatment in different populations, and managing medication overuse headache. [Extracted from the article]

The landscape of acute migraine medication has changed fundamentally in recent years. It has been a gradual, often unnoticed process characterized less by spectacular introduction of new substances than by changes in patients' access to medications and individualized selection of treatment adapted to the patients' needs. Four triptans are now available over-the-counter in Germany which has a major influence on self-medication. The main new introduction was the 5HT1F-agonist lasmiditan as an alternative to triptans., Competing Interests: AH erhielt Zuschüsse, nicht finanzielle Unterstützung und persönliche Honorare von Abbvie/Allergan, Grünenthal, Hormosan, Eli Lilly, Lundbeck, Novartis und TEVA Pharmaceutical. KHK erhielt Zuschüsse, nicht finanzielle Unterstützung und persönliche Honorare von Abbvie/Allergan, Hormosan, Eli Lilly, Lundbeck, Novartis und TEVA Pharmaceutical.HG erhielt Zuschüsse, nicht finanzielle Unterstützung und persönliche Honorare von Amgen, Abbvie/Allergan, Eli Lilly, Lundbeck, Novartis und TevaPharmaceutical. CG erhielt Zuschüsse, nicht finanzielle Unterstützung und persönliche Honorare von Abbvie/Allergan, Novartis und Teva Pharmaceutical., (Thieme. All rights reserved.)