Migraine prevention therapy class reference (2026)
Reference snapshot of approved migraine prevention options including CGRP class, traditional preventives, and emerging mechanisms.
Approved migraine prevention options in 2026 span multiple classes. CGRP-targeted monoclonal antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab) and oral CGRP antagonists (atogepant, rimegepant) are the modern preventive backbone. Traditional preventives (topiramate, propranolol, amitriptyline, valproate) retain a place, particularly in primary care.
Botulinum toxin is approved for chronic migraine and remains a standard option. Emerging mechanisms (PACAP-targeted programs, novel ion channel agents) are in pivotal trials. The acute-treatment side has triptans, ditans, and gepants in active use. The class story is mature; the prescribing question is increasingly about sequencing and co-prescribing rather than novelty.
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