Jakub Tambor, Igor Tambor, Agata Woldan-Tambor, Anna Wiktorowska-Owczarek
Pharmacoterapy of acute migraine attacks – present and future therapeutical options
2024-08-26
Migraine is one of the diseases that significantly impairs functioning and reduces patients’ quality of life. The morbidity of migraine depends on the patient’s gender and age. In the early stages of the disease, symptoms occur episodically, but over time, many patients experience disease progression. Therefore, effective therapy is crucial. The treatment of episodic migraine includes non-pharmacological therapy, which involves patient education for early identification of triggers and lifestyle modifications, as well as pharmacological therapy. Pharmacological treatment in acute migraine episodes aims to provide rapid and effective pain relief and alleviate associated symptoms, while minimizing adverse effects and the risk of medication overuse. Currently, the pharmacotherapy of episodic migraine is based on migraine-specific drugs (ergot derivatives, triptans, ditans, gepants) and non-specific drugs (nonsteroidal anti-inflammatory drugs, analgesics). Acute migraine attacks are often accompanied by nausea and vomiting. Antiemetic medications are administered to alleviate these symptoms. Despite the emergence of new, effective migraine-specific therapies, a significant portion of patients do not achieve an adequate response to treatment. Therefore, there is a need to develop new drugs effective in the acute treatment of migraine with mechanisms of action other than serotoninergic system stimulation or CGRP signaling blockade. Both preclinical and clinical provocation studies have confirmed that the administration of various neuropeptides induces migraine-like attacks. These findings provide a basis for the search for new molecules that could serve as targets for future migraine treatment methods.
This study aims to present the current recommendations for the treatment of episodic migraine. Attention is given to over-the-counter medications recommended for migraine treatment. Additionally, we reviewed drugs as potential future options for the treatment of episodic migraine.
Keywords: ergot derivatives, gepants, acute migraine attacks, triptans, ditans, NDAIDs.
© Farm Pol, 2024, 80(4): 255–266