events (dizziness, fatigue and nausea) than the triptans or another novel medication class, GCRP antagonists. However, they could be an option for patients with cardiovascular risks due to their lack of vasoconstriction . Due to risk of dizziness, those who take lasmiditan should avoid driving 8 hours after taking. Gepants Gepants (eg. rimegepant, ubrogepant, and atogepant) are also a new group of anti migraine drugs, along with ditans. They are calcitonin gene-related peptide (CGRP) receptor antagonists. Gepants have been suggested to have less pain relief at 2 hours compared to triptans. Similar to ditans, they offer another therapy option that does not include vasoconstriction, thus may be suitable for those with cardiovascular risk factors. They are well tolerated with fewer adverse effects compared to triptans . NSAIDS NSAIDS are a nonspecific medication used for abortion of migraines due to their analgesic properties. They can be used for mild to moderate migraines, but are less effective against severe migraines. Similar to the triptans and ergots alkaloids, their use should be limited to less than 10x per month to reduce MOH. Acetaminophen is an analgesic that can also be used, but NSAIDS should be tried first due to their anti-inflammatory properties. However, acetaminophen would be considered first line in pregnant patients. Combination therapy of an NSAID with a triptan can be used when either medication is insufficient alone for migraine relief or recurrence . Long term NSAID use has risks including nephrotoxicity and cardiotoxicity, and long term acetaminophen use is associated with hepatoxicity. If warranted, an antiemetic can be used in combination with an NSAID. Opioids Opioids are not recommended for treatment of acute migraines due to their significant side effect profile, including twice the risk of MOH headache when compared to NSAIDS, acetaminophen or triptans. In addition, their strength of efficacy has showed to be low or insufficient for pain relief of migraines. Importantly, there is also risk of addiction and opioid use disorder. Prevention For patients who require preventive therapy with symptoms such as more than 4 migraines per month or migraines lasting longer than 12 hours, first-line drugs for the prevention of migraine attacks include beta blockers, antidepressants, and anti convulsants. Beta Blockers Beta blockers have been deemed effective options for the prevention of migraines. In particular, metoprolol, timolol and propranolol have the most strength of efficacy. The timeframe to effectiveness in generally within 3 months. Patients with cardiovascular