Lasmiditan is a novel selective 5-HT(1F) receptor agonist. It is both 
scientifically and clinically relevant to review whether a 5-HT(1F) receptor 
agonist is effective in the acute treatment of migraine. Two RCTs in the phase 
II development of lasmiditan was reviewed. In the intravenous placebo-controlled 
RCT, lasmiditan doses of 2.5-45 mg were used, and there was a linear association 
between headache relief (HR) rates and dose levels (P < 0.02). For lasmiditan 
20 mg, HR was 64 % and for placebo it was 45 % (NS). In the oral 
placebo-controlled RCT, lasmiditan doses of 50, 100, 200 and 400 mg were used. 
For HR, all doses of lasmiditan were superior to placebo (P < 0.05). For 
lasmiditan 400 mg, HR was 64 % and it was 25 % for placebo. Adverse events (AEs) 
emerging from the treatment were reported by 22 % of the patients receiving 
placebo and by 65, 73, 87 and 87 % of patients receiving 50, 100, 200 and 
400 mg, respectively. The majority of AEs after lasmiditan 100 and 400 mg were 
moderate or severe. For the understanding of migraine pathophysiology, it is 
very important to note that a selective 5-HT(1F) receptor agonist like 
lasmiditan is effective in the acute treatment of migraine. Thus, migraine can 
be treated with a drug that has no vasoconstrictor ability. While lasmiditan 
most likely is effective in the treatment of migraine attacks it had, 
unfortunately, a high incidence of CNS related AEs in the oral RCT. If confirmed 
in larger studies in phase III, this might adversely limit the use of this 
highly specific non-vascular acute treatment of migraine. Larger studies 
including the parameters of patients' preferences are necessary to accurately 
position this new treatment principle in relation to the triptans.