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New drugs that block a brain chemical are game changers for some migraine sufferers

Unfortunately, because migraine is so complex, it has proved to be a difficult condition to treat. Many migraine therapies are drugs intended for other diseases. Antidepressants, anticonvulsants, blood pressure-lowering drugs and onabotulinumtoxin A — otherwise known as Botox — are all used to prevent migraine. In the 1990s, a class of migraine-specific drug called triptans emerged. These treat attacks as they happen by activating serotonin receptors, and provide at least two hours of pain relief for up to half of people with migraine.

CGRP-targeted drugs are similarly effective. In those who take them to prevent migraine, they almost entirely cease attacks for about 25% of people,…

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  Therapeutic novelties in migraine: new drugs, new hope?

The development of ditans, gepants and anti-calcitonin gene-related peptide monoclonal antibodies for the treatment of migraine is one of the greatest advances in the migraine field. Lasmiditan, rimegepant and ubrogepant will extend our therapeutic armamentarium for managing acute migraine attacks when triptans are not effective or contraindicated due to cardiovascular disorders.

Articles of Interest

Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine

New drug discovery programs shifted the focus to the development of 2 classes of drugs: ditans, a group of antimigraine drugs targeting 5-hydroxytryptamine1F (5-HT1F) receptors, and gepants, a group of calcitonin gene-related peptide (CGRP) receptor antagonists.

Could Newer Migraine Drugs Bring You Relief?

After decades of limited options, migraine sufferers now have more choices.

Ditans for Migraine

One important difference is that triptans constrict blood vessels and ditans do not. Ditans may be an option for people with diseases that affect the heart or blood vessels. Triptans may not be safe for this group of people.

Getting to the Heart of the Matter: Migraine, Triptans, DHE, Ditans, CGRP Antibodies, First/Second-Generation Gepants, and Cardiovascular Risk

Targeted therapies such as calcitonin gene-related peptide (CGRP) antibodies and “Second Generation” CGRP receptor antagonists (Gepants) have not only demonstrated efficacy, but have not resulted in any significant cardiovascular nor other serious adverse events. “First Generation” Gepants were associated with liver toxicity.

How Gepants and Ditans Complement Existing Therapies

Calcitonin gene-related peptide (CGRP) is a protein that carries pain signals along nerves that are involved in generating the headache pain associated with migraine. Gepants work to block CGRP from attaching to its receptor and initiating those pain signals.

Latest Approach for Migraine Sufferers: Stopping Headaches Before They Start

Migraine sufferers have long been told to treat their painful headaches when they feel them coming on. Now, many doctors are prescribing daily drugs to prevent migraines from ever starting at all.

Many Migraines Can Be Prevented With Treatments, But Few People Use Them

Preventive treatment can reduce migraines by 50 percent. "For a given patient, half [the migraines] is usually a significant improvement," says Flippen. "If you go from 15 headache days per month down to seven, that's a significant change." In April, the American Academy of Neurology released new guidelines to help physicians treat migraine patients and help them reduce both frequency and severity of headaches.

Migraine Medication: Everything You Need to Know About Finding Relief

Migraine is a complex disease that can be challenging to treat. There are tons of meds to choose from but it can take some trial and error (and lots of patience) to find the ones that work for you.

New Migraine Medications: Oral Gepants, Ditan Tablet, and More

Small molecule CGRP receptor antagonists may be utilized as migraine abortives or preventive. Plus, a look at the new intravenous CGRP inhibitor and the abortive ditan tablet.

On the cusp of a new era for migraineurs

For Allergan, developing treatments for CNS disorders, specifically in migraine, has been a key focus for decades. BOTOX® (onabotulinumtoxinA) has an extensive history of helping patients with a number of therapeutic conditions — the largest of which is chronic migraine.

Oral and Intranasal Triptans for Migraine

Learn about how triptans work and who they can help, as well as dosing, side effects, and contraindications.

The Discovery and Development of the Triptans, a Major Therapeutic Breakthrough

The drug discovery programs that led to the development of the triptans were determined by the membership of the American Headache Society to be the most important breakthrough in headache medicine in the last 50 years. Dr. Humphrey, who spearheaded the drug discovery, recounts the pioneering work that took place and examines its therapeutic impact.

The ditans, a new class for acute migraine: Minireview

Lasmiditan (LDT), a new drug, was approved by the Food and Drug Administration in October 2019 for acute migraines with or without aura. LDT belongs to a new class of drugs “-ditans,” in which the mechanism is different from the triptans since it does not show vasoactive effects.

The Journey of the Non-Vascular Relief for Migraine: From 'Triptans' To 'Ditans'

Having a group of drugs with a nonvascular mechanism of action, devoid of unwanted effects with a different spectrum of indication and contraindications, is the need of the hour to expand the armamentarium available to tackle acute migraine attack.

The New Cutting-Edge Treatment for Migraines

The new sexy business – by which I mean “profitable” – in the treatment of chronic migraine is therapy targeted at the calcitonin gene–related peptide receptor. The past few years have brought several of these to market as ongoing maintenance therapy. This looks at a different application – acute migraine. Their proposed unmet need – the slice of patients for whom various triptans are ineffective.

Understanding Migraine Medications

There are two primary forms of treatments for migraine: acute and preventive medications. Acute medication is used during a migraine attack to relieve pain and to stop the migraine from progressing...

What are the new drugs for the treatment of migraines?

The newest drugs for the acute treatment of migraine are Nurtec ODT (rimegepant) and Ubrelvy (ubrogepant), both orally-administered calcitonin gene-related peptide (CGRP) receptor antagonists (gepants).

When It Comes To Migraines, the Drugs Are Almost As Bad As the Pain

For migraine sufferers, picking the right medication can be a real headache.

Resources

Triptans

Triptans are a class of medications used in the treatment of migraine headaches. Triptans act as antimigraine agents by selectively binding to the serotonin receptors 5-HT1B and 5-HT1D. Triptan binding to the vascular 5-HT1B receptors leads to vasoconstriction of the cranial arteries, which painfully dilate during a migraine attack.

Ditans and Gepants

Among the wave of new treatment classes, devices and medicines currently in development are ditans and gepants. Learn more about how these breakthrough treatments are different, how well they work...

Emgality

If you’re only treating migraine after it starts, you may want to think about a preventive treatment. Emgality can cut monthly migraine days in half.