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How do the currently used prophylactic agents work in migraine?
1Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK. peterg@brain.ion.ucl.ac.uk
Cephalalgia : an International Journal of Headache
|April 1, 1997
Summary
Migraine prevention medications are effective but poorly understood. This review examines proposed mechanisms including 5HT2 antagonism and effects on voltage-sensitive channels, excluding plasma protein extravasation.
Area of Science:
- Neurology
- Pharmacology
Background:
- Frequent migraine attacks necessitate effective preventive treatments.
- The precise mechanisms of action for many migraine prophylactic agents remain unclear.
- Proposed mechanisms include 5HT2 antagonism, plasma protein extravasation modulation, aminergic control modulation, and membrane stabilization.
Purpose of the Study:
- To review the evidence supporting proposed mechanisms of action for migraine preventive agents.
- To critically evaluate these mechanisms in the context of current migraine pathophysiology understanding.
Main Methods:
- Literature review and synthesis of existing research.
- Examination of evidence for proposed mechanisms: 5HT2 antagonism, central aminergic control modulation, and voltage-sensitive channel effects.
- Exclusion of plasma protein extravasation mechanism for this specific review.
Main Results:
- Evidence supporting 5HT2 antagonism as a migraine prevention mechanism is discussed.
- The role of central aminergic control systems in migraine prophylaxis is evaluated.
- The contribution of membrane stabilization via voltage-sensitive channels is examined.
Conclusions:
- Current understanding of migraine preventive agent mechanisms is incomplete.
- Further research is needed to elucidate the precise actions of these therapies.
- Understanding these mechanisms is crucial for optimizing migraine management strategies.