New therapeutic approaches for the prevention and treatment of migraine

  title={New therapeutic approaches for the prevention and treatment of migraine},
  author={Hans Christoph Diener and Andrew Charles and Peter J. Goadsby and Dagny Holle},
  journal={The Lancet Neurology},

New Therapeutic Approaches for the Treatment of Migraine

Future pharmacological target and compounds which have been developed for the acute attacks of migraine including: serotonin 5-HT 1F receptor agonists, nitric oxide synthase inhibitors, calcitonin gene-related peptide (CGRP) receptor antagonists, cation channel subfamily vanilloid member 1 (TRPV1) receptor modulators, glutamate receptors antagonists and PAC1 receptor antagonists are reviewed.


Migraine therapy ranges from the use of simple analgesics such as nonsteroidal anti (NSAIDs) or acetaminophen to triptans, antiemetics, or the less commonly used dihydroergotamine, which is usually more effective if they are given early in the course of the headache.

Why is the therapeutic effect of acute antimigraine drugs delayed? A review of controlled trials and hypotheses about the delay of effect

A general delay of effect in oral antimigraine drugs is strongly indicated and is likely that a complex antimigraines system with more than 1 site of action is involved.

The locus of action of CGRPergic monoclonal antibodies against migraine: peripheral over central mechanisms.

The present review has attempted to summarize and discuss the current evidence on the probable sites of action of these monoclonal antibodies against CGRP or its receptor as a novel pharmacotherapy to treat migraine.

Novel Approaches to the Development of Antimigraine Drugs: A Focus on 5-HT2A Receptor Antagonists

The review focuses on the description of 5-HT2A receptors as a promising target for the development of novel antimigraine drugs and new trends in the search for 5- HT2A antagonists among compounds synthesized based on a serotonin bioisostere, benzimidazole.

Human models of migraine — short-term pain for long-term gain

The existing experimental models of migraine in humans, including those that exploit nitric oxide, histamine, neuropeptide and prostaglandin signalling, are summarized and the development and use of these models in the discovery of molecular pathways that are responsible for initiation of migraine attacks are described.

The bottom-up approach: Non-invasive peripheral neurostimulation methods to treat migraine: A scoping review from the child neurologist's perspective.

  • C. BörnerGiada Urban M. Bonfert
  • Medicine, Psychology
    European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
  • 2021

Efficacy of Calcitonin Gene-Related Peptide Antagonists in the Treatment of Acute Migraine: A Systematic Review and Meta-analysis

With regard to pain freedom and pain relief two hours post-dose, CGRP antagonists are more efficacious than placebo in the treatment of acute migraine but there is insufficient evidence to demonstrate superior efficacy of C GRP antagonists over triptans.

Manual therapy as a prophylactic treatment for migraine: design of a randomized controlled trial

The design for and discuss the feasibility of a pragmatic, randomized controlled trial on the effectiveness of a multimodal manual therapy (MT) treatment compared to usual care by the general practitioner (GP) for the prophylactic treatment of migraine.



Comparative efficacy of triptans for the abortive treatment of migraine: A multiple treatment comparison meta-analysis

Eletriptan is the most likely of all triptans to produce a favorable outcome and is likely to produce pain-free responses that were sustained in the populations studied, and triptans appear to offer differing treatment effects.

Acute treatment of migraine with the selective 5-HT1F receptor agonist lasmiditan – A randomised proof-of-concept trial

The non-vascular, neural mechanism of action of lasmiditan may offer an alternative means to treat migraine especially in patients who have contra-indications for agents with vasoconstrictor activity.

Towards a Definition of Intractable Headache for Use in Clinical Practice and Trials

The definition of intractability is explored to provide some standard against which to test new treatments for patients, who have been called intractable and do not respond to regulatory-approved and other conventional preventive therapies.

Intranasal Civamide for the Acute Treatment of Migraine Headache

Based upon the results of this study, intranasal civamide may be effective in the acute treatment of migraine headache and should be substantially more effective for prophylaxis than acutereatment of migraine.

Randomized controlled trial of the CGRP receptor antagonist telcagepant for migraine prevention

This study provides Class II evidence that in patients with migraine, telcagepant taken daily reduces headache days by 1.4 days per month compared to placebo and causes 2.5% of patients to have elevations of serum ALT levels.

Randomized controlled trial of the orexin receptor antagonist filorexant for migraine prophylaxis

Data fail to provide evidence that antagonism of orexin receptors with filorexant, when administered at night, is effective for migraine prophylaxis.