Introduction: Migraine is one of the most common neurological disorders. 
Nowadays, the 5-HT1B/1D receptor agonists, namely triptans, are considered as 
the standard of care for migraine acute treatment. However, triptans have 
limitations in some patients, such as incomplete pain relief, headache 
recurrence, and cardiovascular contraindications. New 5-HT1F receptor agonists, 
namely ditans, and calcitonin gene-related peptide receptor antagonists, namely 
gepants, have been developed as migraine-specific treatments.Areas covered: This 
paper reviews the available data from RCTs to assess the clinical efficacy, 
safety, and tolerability profile of lasmiditan, rimegepant, and ubrogepant for 
the acute treatment of migraine and atogepant for the prevention of 
migraine.Expert opinion: Available data suggest that lasmiditan, rimegepant, and 
ubrogepant might not have a clinical efficacy similar to triptans. Lasmiditan 
did not cause the typical triptan side effects but was associated with central 
nervous system side effects, causing temporary driving impairment. On the 
contrary, the new generation of gepants showed a placebo-like tolerability 
profile and the absence of a specific pattern of side effects. Future studies on 
lasmiditan and gepants with respect to established effective comparators are 
mandatory to support phase III results and to help clinicians to balance the 
benefit/risk profiles of the various acute and preventive medications.