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Advent Of A New Generation Of Antimigraine Medications

A. Recober, A. Russo
Published 2007 · Medicine

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This chapter will address recent developments in the treatment of migraine. The recent promising clinical trials using a new antimigraine medication, BIBN4096BS, heralds the advent of a new generation of therapeutics. BIBN4096BS targets the receptor for the neuropeptide calcitonin gene–related peptide (CGRP), which appears to play a causal role in migraine pain. We will discuss the rationale and therapeutic implications of modulating CGRP, including its potential for acting at multiple sites in the trigeminovasculature. We will then discuss the currently used acute and preventative pharmacological treatments. Of particular interest is the increasing evidence that antiepileptic drugs may be an effective prophylactic treatment for migraine. Future strategies to selectively downregulate CGRP synthesis and the potential use of migraine drugs for other forms of trigeminal-mediated pain, such as temporomandibular disorder and trigeminal neuralgia, will be explored. Keywords: calcitonin gene-related peptide (CGRP); migraine; triptan; trigeminal ganglion; anti-epileptic; CGRP receptor antagonist; neurogenic inflammation; neuropeptide; neurovascular headache; pathophysiologic mechanisms; acute migraine therapies; preventive migraine therapies
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