There are many new treatment options available for migraine and more are coming. 
Three calcitonin gene-related peptide (CGRP) antagonist monoclonal antibodies 
have been approved and a 4th is due in early 2020. Small molecule CGRP 
receptor-blocking oral compounds, both for acute care and prevention, are also 
coming. Four neurostimulators are available, with others on the way. New acute 
treatments coming soon include the 5HT1F agonist lasmiditan, a zolmitriptan 
intradermal micro-needle patch, and a nasal mist sumatriptan with a permeability 
enhancer. Farther out, three novel dihydroergotamine delivery systems, and a 
liquid-filled capsule of celecoxib show early promise. A new, safer form of 
methysergide is in the works, as is a longer-duration onabotulinumtoxinA. As 
always with new products, questions regarding safety, tolerability, cost, and 
insurance coverage will need to be addressed. Despite these concerns and 
uncertainties, a robust headache treatment pipeline is good for patients who are 
not satisfied with the results of their treatment and/or cannot tolerate 
existing treatments.