Annals of Neurology and Neuroscience | Volume 1, Issue 1 | Review Article | Open Access

Comparative Effectiveness of CGRP Antagonists Versus Traditional Prophylactic Agents in Migraine: A Comprehensive Review

Qasim Zia*

Altaf Hussain1, Qasim Zia2*, Muhammad Salman Khan2, Muhammad Usama Khalid2, Omer Ismail Khalid3, Muhammad Hamza Khan4, Ayesha Abbas5, Hajra Azmat6

1DHQ Hospital, Bhakkar

2Multan Medical & Dental College, Multan

3Arrahma Mental Hospital, Multan

4Nishtar Medical University, Multan

5Bahawal Victoria Hospital, Bahawalpur

6M.Islam Medical & Dental College, Gujranwala

*Correspondence to: Qasim Zia 

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Abstract

Migraine is a highly prevalent and disabling neurovascular disorder with substantial socioeconomic impact worldwide. Preventive pharmacotherapy remains the cornerstone for reducing migraine frequency, severity, and associated disability. Traditional prophylactic agents — including beta-blockers, antiepileptics, antidepressants, and calcium channel blockers — have long been utilized despite limitations in efficacy, tolerability, and adherence. The emergence of calcitonin gene-related peptide (CGRP) antagonists, including monoclonal antibodies and small-molecule gepants, represents a paradigm shift in migraine prevention. These agents target migraine-specific pathophysiological pathways, offering improved efficacy and tolerability. This review critically examines and compares the effectiveness, safety, tolerability, and clinical utility of CGRP antagonists with conventional prophylactic therapies. Evidence from randomized controlled trials, systematic reviews, and meta-analyses suggests that CGRP-targeted therapies demonstrate superior efficacy in reducing monthly migraine days and exhibit a more favorable adverse effect profile. However, considerations such as cost, long-term safety, and accessibility remain challenges. This manuscript aims to provide a comprehensive and balanced evaluation to guide clinicians in evidence-based migraine management.

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Citation:

Altaf Hussain, Qasim Zia, Muhammad Salman Khan, Muhammad Usama Khalid, Omer Ismail Khalid, Muhammad Hamza Khan, et al. Comparative Effectiveness of CGRP Antagonists Versus Traditional Prophylactic Agents in Migraine: A Comprehensive Review. Anna Neur & Neurosci. 2026;1(1):1-7.