Anti-epileptic drugs in the preventive treatment of migraine headache: a brief review

Pini, Luigi Alberto; Lupo, Lucia

doi:10.1007/s101940170041

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…18 However, botulinum toxin A has not been demonstrated to be more efficacious than placebo for episodic migraine 19 and is only approved for the prevention of chronic migraine in the USA and Europe. The results of our study suggest that galcanezumab, a CGRP monoclonal antibody, may be more rapidly acting than many other conventional preventive treatments currently available 20,21 and may overcome the challenges associated with conventional preventive treatments, including lack of efficacy, low adherence, and high discontinuation rates. 5,6,22 The current study showed that approximately half of the patients receiving galcanezumab experienced ≥50% response at each week from weeks 1 to 4.…”

Section: Discussionmentioning

confidence: 79%

Early Onset and Maintenance Effect of Galcanezumab in Japanese Patients with Episodic Migraine

Igarashi¹,

Shibata²,

Ozeki³

et al. 2021

JPR

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Section: Discussionmentioning

confidence: 79%

Early Onset and Maintenance Effect of Galcanezumab in Japanese Patients with Episodic Migraine

Igarashi¹,

Shibata²,

Ozeki³

et al. 2021

JPR

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“…Inhibition of NMDA in turn inhibits glutamate, which has been implicated in cortical spreading depression propagation, central sensitization and activation of nociceptive neurons ( 8 ). Other parenteral treatment options include dihydroergotamine, which inhibits vasoconstriction, and CGRP release at 5HT1B/D receptors ( 13 ), chlorpromazine which antagonizes dopamine ( 14 ) and sodium valproate, which inhibits GABA uptake and inhibits voltage-sensitive channels while stimulating GABA synthesis ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Intravenous Lidocaine and Ketamine Infusions for Headache Disorders: A Retrospective Cohort Study

et al. 2022

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IntroductionThe use of lidocaine (lignocaine) and ketamine infusion in the inpatient treatment of patients with headache disorders is supported by small case series. We undertook a retrospective cohort study in order to assess the efficacy, duration and safety of lidocaine and ketamine infusions.MethodsPatients admitted between 01/01/2018 and 31/07/2021 were identified by ICD code and electronic prescription. Efficacy of infusion was determined by reduction in visual analog score (VAS), and patient demographics were collected from review of the hospital electronic medical record.ResultsThrough the study period, 83 infusions (50 lidocaine, 33 ketamine) were initiated for a headache disorder (77 migraine, three NDPH, two SUNCT, one cluster headache). In migraine, lidocaine infusion achieved a ≥50% reduction in pain in 51.1% over a mean 6.2 days (SD 2.4). Ketamine infusion was associated with a ≥50% reduction in pain in 34.4% over a mean 5.1 days (SD 1.5). Side effects were observed in 32 and 42.4% respectively. Infusion for medication overuse headache (MOH) led to successful withdrawal of analgesia in 61.1% of lidocaine, and 41.7% of ketamine infusions.ConclusionLidocaine and ketamine infusions are an efficacious inpatient treatment for headache disorders, however associated with prolonged length-of-stay and possible side-effects.

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“…There do not seem to have been formal systematic studies or controlled clinical trials of pharmacological agents in the management of these rather uncommon aura situations. However, there are reports based on small numbers of cases that certain measures, such as the use of antiseizure medications or calcium channel antagonists, may be effective in preventing their occurrence or in shortening their durations [18,19].…”

Section: The Migraine Auramentioning

confidence: 99%

“…The available literature reports that various drugs believed to act at other receptor types that have already been identified as probably playing a role in the pathogenesis of migraine headache are currently under investigation or are being developed [19,42,43]. The receptors involved in their actions include pituitary adenyl cyclase activating peptide receptors, certain classes of glutamate receptor, orexin receptors, receptors of the endocannabinoid system [44], and perhaps receptors subserving the near final stage headacheproducing molecular mechanism by blocking nitric oxide synthase activity or ATP-sensitive potassium channels [45].…”

Section: Agents Acting At Other Receptor Typesmentioning

confidence: 99%

Potentially Remediable Shortcomings in the Contemporary Drug Treatment of Migraine

Eadie

2022

Future Pharmacology

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Despite the availability over the past decade of a number of new pharmaceutical agents with different mechanisms of action from those of the drugs used previously, the contemporary drug therapy of migraine attacks falls rather short of what would be desirable, while the pharmacological attempt to prevent further attacks appears to prove unsatisfactory about as often as it is successful. The present paper explores reasons for these shortcomings in both the earlier and the current drug therapy of the disorder. Significant major contributory factors appear to be an incomplete understanding of the underlying pathogenic mechanisms of the various stages of the migraine attack, less than optimal pharmacokinetic characteristics of many of the drugs used, and migraine sufferers failing to employ the available drugs to their best advantage. New drugs developed in the light of a more complete understanding of the molecular basis of migraine pathogenesis, together with awareness of pharmacokinetic desiderata in relation to treating and preventing migraine attacks, may go some way towards remedying the situation, but patient decision making may prove more difficult to modify.

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Anti-epileptic drugs in the preventive treatment of migraine headache: a brief review

Cited by 5 publications

References 12 publications

Early Onset and Maintenance Effect of Galcanezumab in Japanese Patients with Episodic Migraine

Early Onset and Maintenance Effect of Galcanezumab in Japanese Patients with Episodic Migraine

Intravenous Lidocaine and Ketamine Infusions for Headache Disorders: A Retrospective Cohort Study

Potentially Remediable Shortcomings in the Contemporary Drug Treatment of Migraine

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