Future trends in drugs for migraine prophylaxis.
Migraine prevention hinges on a variety of non-specific drugs that mainly reduce neuronal hyperexcitability, the putative pathophysiological hallmark for migraine. The improved knowledge about migraine circuitry and neurobiology has prompted research to develop new specific migraine preventive medications targeted to innovative sites and mechanisms. Drugs designed to inhibit cortical spreading depression, for example tonabersat, might offer a useful option for the management of migraine with aura but not for migraine without aura. Inducible nitric-oxide synthase (iNOS) inhibition seems ineffective as a prophylactic strategy. Results are awaited from recent and ongoing phase II trials with glutamate receptor antagonists, third-generation antiepileptics, melatonin agonists, vitamin D3 and statins.
Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, via della Pisana 235, 00163 Rome, Italy. piero.barbanti@sanraffaele.it
Piero
P
Barbanti
Cinzia
C
Aurilia
Gabriella
G
Egeo
Luisa
L
Fofi
D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000639:trends; D005544:Forecasting; D006801:Humans; D008881:Migraine Disorders / Q000503:physiopathology* / Q000517:prevention & control*; D028321:Plant Preparations / Q000627:therapeutic use
D000700:Analgesics; D000927:Anticonvulsants; D028321:Plant Preparations; D019274:Botulinum Toxins, Type A