title: A possible new option for migraine management: agomelatine.
abstract: BACKGROUND
  Migraine is a primary headache disorder characterized by recurrent episodes of headache associated with gastrointestinal, neurologic, and autonomic symptoms. Some evidence in literature suggests that the melatonergic system possibly plays an important role in the pathogenesis of migraine. Few studies have been performed on the use of melatonin as an antimigraine agent. Other than amitriptyline, few antidepressants have been found to be efficacious for migraine prophylaxis. Among antidepressants, agomelatine has a novel neurochemical mechanism. It is an melatonin receptor 1 and melatonin receptor 2 melatonergic receptor agonist and a selective antagonist of the 5-hydroxytryptamine (serotonin) receptor 2C receptors.
  
  
  METHODS
  We report two cases of patients with migraine successfully treated with agomelatine; one patient presented with comorbid depression, whereas the other had no comorbidities.
  
  
  CONCLUSIONS
  Given its specific mechanism of action and similarity with melatonin, agomelatine may be a promising new treatment option for migraine prophylaxis. The potential therapeutic action of agomelatine could be due to its synergistic action on both melatonergic and 5-HT2C receptors.
authors.affiliation: Department of Neuroscience, Catholic University of Rome, Rome, Italy. ricguglielmo@gmail.com
authors.forename: Riccardo
authors.initials: R
authors.lastname: Guglielmo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
authors.forename: Luigi
authors.initials: L
authors.lastname: Janiri
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D015897:Comorbidity; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008550:Melatonin / Q000819:agonists*; D008881:Migraine Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D055502:Secondary Prevention; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D008550:Melatonin; C084711:agomelatine; D009281:Naphthalenes