Neurológia pre prax 3/2017

New perspectives of the treatment of migraine

The acute treatment of migraine attacks is so far limited to the use of simple analgesics, non-steroidal anti-inflammatory drugs, ergotamines and triptans. On the basis of our knowledge about pathophysiology of migraine, which is mentioned in this article, new medicaments for the treatment of acute migraine attacks have been developed targeted especially to calcitonin gene–related peptide (CGRP) and serotonin 5-HT 1F receptors. Other therapeutic targets are mentioned, such as glutamate, combination of 5-HT1B/1D receptors and neuronal nitric oxide synthesis and medicament influencing cortical spreading depression. In the prophylaxis of migraine, the most promising new approach are humanized antibodies against CGRP or the CGRP receptor. Non–invasive and invasive neuromodulation techniques are being developed at present in the acute and prophylactic treatment.

Keywords: calcitonin gene-related peptid (CGRP), serotonin 5-HT1F receptors, nitric oxide, glutamate, cortical spreading depression, monoclonal antibodies against CGRP or CGRP receptors, anticonvulsant drugs