Migraine is an important socioeconomic burden and is ranked the sixth cause of 
years of life lost because of disability in the general population and the third 
cause of years of life lost in people younger than 50 years. The cornerstone of 
pharmacological treatment is represented by the acute therapy. The serotonin 
(5-hydroxytryptamine [5-HT]) receptor subtype 1B/1D agonists, called triptans, 
are nowadays the first-line acute therapy for patients who experience 
moderate-to-severe migraine attacks. Unfortunately, a high percentage of 
patients are not satisfied with this acute treatment, either for lack of 
response or side effects. Moreover, their mechanism of action based on 
vasoconstriction makes them unsuitable for patients with previous cardio- and 
cerebrovascular diseases and for those with uncontrolled hypertension. Since the 
introduction of triptans, no other acute drug class has passed all developmental 
stages. The research for a new drug lacking vasoconstrictive effects led to the 
development of lasmiditan, a highly selective 5-HT1F receptor agonist with 
minimized interactions with other 5-HT receptor subtypes. Lasmiditan is 
considered to be the first member of a new drug category, the neurally acting 
anti-migraine agent (NAAMA). Phase II and III trials had shown superiority 
compared to placebo and absence of typical triptan-associated adverse events 
(AEs). Most of the AEs were related to the central nervous system, depending on 
the high permeability through the blood-brain barrier and mild to moderate 
severity. The results of ongoing long-term Phase III trials will determine 
whether lasmiditan will become available in the market, and then active triptan 
comparator studies will assess patients' preference. Future studies could then 
explore the safety during pregnancy and breastfeeding or the risk that overuse 
of lasmiditan leads to medication overuse headache.