After the triptans, a calcitonin gene-related peptide blocker (telcagepant) is 
the first acute medicine that has been developed primarily for treatment of 
acute migraine. Otherwise, the new drugs have been developed first for other 
purposes, like anticonvulsants, antihypertensives and antidepressants used for 
migraine prophylaxis. For acute attacks, a new way to administer a traditional 
drug like dihydroergotamine is under way, and documentation of efficacy in 
migraine has been gained for some commonly used painkillers and 
anti-inflammatory drugs, and for some herbal extracts. Based on insights into 
the basic pathophysiological mechanisms of the disorder, some drugs have been 
developed which seem promising in early phase II studies (NOS inhibitors and 
5HT1F-receptor agonists). In the future, development and enhancements of 
existing medicines must be accompanied by increased efforts to develop truly new 
migraine drugs based on knowledge of the pathophysiology if one wishes to reduce 
substantially the great burden migraine poses on patients and society.