Serotonin receptors and the acute attack of migraine

The development of serotonin (5HT) agonists that have highly specific receptor profiles has fueled the study of 5HT receptor pharmacology and in particular the pharmacology of the 5HT1 sub-class of receptors. The currently accepted classification of 5HT receptors includes seven classes known as 5HT1 through 5HT7 and the class most implicated in migraine 5HT1, which consists of the A, B, D, E, and F sub-types. Currently, effective and relatively specific anti-migraine compounds, as a group, are potent 5HT1B/1D agonists. Their possible mechanisms of action include carotid territory vasoconstrictor effects and inhibitory effects on both the peripheral and central terminals of the trigeminal innervation of the pain-producing intracranial structures. Future drug development will target these individual mechanisms to dissect out which, if any, determines the clinical efficacy of the compounds.