title: Novel strategies for the treatment of migraine attacks via the CGRP, serotonin, dopamine, PAC1, and NMDA receptors.
abstract: BACKGROUND
  Migraine is a common, paroxysmal, and disabling primary headache with a high personal and socioeconomic impact. It involves ∼ 16% of the general population. During the years, a number of hypotheses have been put forward concerning the exact pathomechanism, but the final solution is still undiscovered.
  
  
  METHODS
  Although the origin is enigmatic, parallel therapeutic efforts have been developed. Current attack therapy does not meet the expectations of the patients or the doctors. This article, based on a PubMed search, reviews the novel pharmacological possibilities that influence the peripheral and central sensitization involved in the disease.
  
  
  CONCLUSIONS
  In order to overcome the therapeutic insufficiency, a calcitonin gene-related peptide receptor antagonist without the side-effect of liver transaminase elevation is required. Another therapeutic option is to develop a neurally acting antimigraine agent, such as a serotonin-1F receptor agonist, with low adverse central nervous system events. Development of a potent dopamine receptor antagonist is necessary to diminish the premonitory symptoms of migraine. A further option is to decrease the headache intensity with a pituitary adenylate cyclase-activating polypeptide type 1 receptor blocker which can cross the blood-brain barrier. Finally, synthetic kynurenine analogues are required to block the pain transmission in the activated trigeminal system.
authors.affiliation: University of Szeged, Department of Neurology , Semmelweis u. 6, H-6725, Szeged , Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Tajti
authors.forename: Anett
authors.initials: A
authors.lastname: Csáti
authors.forename: László
authors.initials: L
authors.lastname: Vécsei
mesh_terms: D000818:Animals; D000077221:Calcitonin Gene-Related Peptide Receptor Antagonists; D018492:Dopamine Antagonists / Q000627:therapeutic use; D015195:Drug Design; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D016194:Receptors, N-Methyl-D-Aspartate; D051237:Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I / Q000037:antagonists & inhibitors; D011985:Receptors, Serotonin / Q000187:drug effects; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use; D000096642:Receptor, Serotonin, 5-HT1F
chemical_list: D000077221:Calcitonin Gene-Related Peptide Receptor Antagonists; D018492:Dopamine Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D051237:Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I; D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists; D000096642:Receptor, Serotonin, 5-HT1F
keywords: 5-hydroxytryptamine 1F receptor agonist; N-methyl-D-aspartate receptor inhibitors; calcitonin gene-related peptide receptor antagonists; dopamine receptor antagonists; migraine attack therapy; pituitary adenylate cyclase-activating polypeptide type 1 receptor