Antiepileptic drugs in migraine prophylaxis

Abstract

IntroductionThe decision to begin prophylactic therapy for the treatment of migraine depends on the frequency and the severity of the attacks, and to what extent they alter the quality of life of the patients. According to the Diagnostic and Therapeutic Guidelines for migraine and cluster headache of the Italian Society for the Study of Headaches [1], the presence of at least 2 attacks of migraine per month or lasting 4 or more days per month, which do not completely respond to symptomatic therapy, are indications to begin prophylactic therapy.A state of hyperexcitability of the cerebral cortex is considered the neuropathophysiologic basis of migraine, as in epilepsy, and in fact the two pathologies are often comorbid [2]. In a population study, Ottman and Lipton [3] demonstrated that epilepsy and migraine are closely linked pathologic conditions, independent of seizure aetiology, age at first onset and type of crisis. These features, which are shared by these pathologies characterised by attacks, suggest a common pathogenesis involving membrane excitability upon which the antiepileptic drugs can act.From this point of view, the studies of efficacy and tolerability confirm and delineate antiepileptics as very promising drugs in the panorama of the prevention of migraine and other head pain.Antiepileptic and antimigraine drugs act on the nociceptive mechanisms mediated by GABA or glutamate neurotransmission, or both [4]. GABA is the major inhibitory neurotransmitter in the central nervous system and its presynaptic release occurs by a calcium-dependent mechanism [5]. Valproate and gabapentin interfere with GABA metabolism, inhibiting its degradation and transformation into succinate [6], and topiramate potentiates GABA-mediated inhibition by facilitating receptor action [7]. GABA binding to its receptors causes cellular hyperpolarisation and inhibition of postsynaptic transmission. All these drugs modulate the activity of calcium, sodium and potassium ion channels by hyperpolarising and stabilising the membrane [4]. Abstract Research in the field of headache treatment has experienced a marked impetus in the last few years. In the era of the triptans, the treatment modality of this disease has been revolutionised, and though most of the studies conducted have investigated the symptomatic treatment of migraine, less attention has been dedicated to migraine prophylaxis. This review considers the current data available in the literature regarding the use of antiepileptic drugs in migraine prophylaxis, noting the clinical studies that have yielded statistically significant data.

Development of novel microsphere structured – calcium tungstate as efficacious electrocatalyst for the detection of antibiotic drug nitrofurantoin

“…[4][5][6] Nitrofurantoin (NFT) is an antibiotic drug that is produced through a chemical process strategy by 5-nitro-2-furaldehyde and 1-aminohydantoin sulfate, 7,8 and it shows notable activity against Gram-negative and Gram-positive microbes. 9 In line with this, NFT reacts over some bacteriophages, salmonella, Escherichia coli, and Enterobacter. 10,11 Especially, this drug is utilized as a remedy for urinary tract infections (UTIs) in humans, and it is employed as an additive material in the livestock industry.…”