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Published on: June 2, 2014
Triptan-induced latent sensitization: a possible basis for medication overuse headache.
Milena De Felice1, Michael H Ossipov, Ruizhong Wang
1Department of Pharmacology, University of Arizona College of Medicine, Tucson, AZ, USA.
Annals of Neurology
|April 8, 2010
Summary
Triptan overuse in migraine treatment can cause medication overuse headache by inducing a latent sensitization in the nervous system. This sensitization increases migraine frequency and sensitivity to triggers.
Area of Science:
- Neuroscience
- Pharmacology
- Pain Research
Background:
- Triptans are a primary treatment for moderate to severe migraines.
- Medication overuse headache (MOH) is a common complication of frequent triptan use.
- The neural mechanisms driving MOH from triptans remain unclear.
Purpose of the Study:
- To investigate the neural mechanisms underlying medication overuse headache (MOH) induced by triptans.
- To identify specific neural adaptations in dural afferents following triptan administration.
Main Methods:
- Rats received systemic triptan administration via injections or continuous infusion.
- Cutaneous allodynia was assessed by measuring sensory thresholds.
- Peptidic neurotransmitter expression in dural afferents was analyzed using immunofluorescent histochemistry.
- Calcitonin gene-related peptide (CGRP) levels in blood were measured using ELISA.
Main Results:
- Repeated triptan administration induced time-dependent, reversible cutaneous allodynia.
- Triptan exposure increased CGRP expression in trigeminal dural afferents, persisting post-treatment.
- Following triptan exposure, rats exhibited enhanced allodynia and elevated blood CGRP levels upon nitric oxide donor challenge.
- A state of latent sensitization with persistent pronociceptive neural adaptations was observed.
Conclusions:
- Triptan overuse can lead to neural adaptations, causing latent sensitization.
- This sensitization may increase susceptibility to migraine triggers.
- Latent sensitization provides a potential mechanism for migraine transformation into medication overuse headache.
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