Unpredictability Of Migraines: Future Approaches

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Migraine is a primary headache disorder which lasts from 2 to 72 hours and it almost affects one half part of the brain.

Some strong drugs were used to halt migraines headache but were not much effective until taken within first hours of migraine . And also some people cannot take it if have problem like heart disease, blood pressure, etc.

The drugs are taken which affects brain chemicals or blood vessels inflammations that leads to migraine which is to be taken daily so that the pain disappears.

Nowadays more focus is on migraine drug that do not have limitation or side effect or lowering of blood pressure. FDA is currently receiving a new migraine drug called trexima. it is combination of Imitrex (sumitriptan ) and naproxen sodium. Triptan helps in dilating blood vessels. This dilating blood vessels leads to migraine pain, anti inflammatory drug prevent release of inflammation triggering enzyme.

Another successful new approach for treatment of acute migraine targets on calcitonin gene related peptide (CGRP) and serotonin (5-hydroxytryptamine, 5HT1f) receptors.

Other approaches targets the transient receptors, potential vanelloid (TRPV1) receptor, glutamate or combination of 5HT receptors have been investigated but not been successful during clinical trials. In migraine problem most promising approach is humanised anti-bodies against calcitonin gene related peptide or calcitonin gene related peptide receptor. Non invasive and invasive neuro-modulation approaches also show promise as acute and preventive therapies. New medicines develop are targeted at neural site of action. Serotonin receptor is proved to be effective in phase-II study and have no vascular action. Calcitonin receptor are another promising receptor for treating acute migraine.

Recent studies have shown that excessive use of symptomatic medication on daily basis may lead to chronic migraine thus prophylactic and symptomatic medication become ineffective with this neural target and improvement in therapeutic advances the problem or side effect arising from drugs is lowered and more emphasis on patient care is taken, migraine drugs sometimes proved to be dangerous for patients with high blood pressure or any heart related problems therefore novel approaches were made and drugs with less side effects are available in market and are comparatively more effective than older ones.

Therefore CGRP is a drug that does not cause contraction on blood vessels so there would be less worries for patient with heart disease. This drug works by inhibiting protein released during inflammation called calcitonin gene related peptide. However, it may take time until we see it FDA-approved."

Written By:

Archi Desai

Dhwaniben Patel

(Doctor of Pharmacy)