Skip to main content

Advertisement

SpringerLink
Log in

Emerging treatments for the primary headache disorders

  • NEWS ON TREATMENT OF PRIMARY HEADACHES AND NEUROSTIMULATION
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Migraine and cluster headache are common, episodic, often chronic and disabling disorders of the brain. Although there are many standard treatment techniques, none are ideal. This article reviews various novel pharmacologic and device-related treatments for migraine and cluster headache. Emphasis is given to recent advances in the development of monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) and its receptor, including promising results from phase 2 trials studying the safety and efficacy of LY2951742, ALD403 and TEV-48125, three anti-CGRP mAbs. Other new pharmacologic treatments discussed include the 5-HT1F receptor agonist lasmiditan and glial cell modulator ibudilast. Also reviewed is neuromodulation for migraine and cluster headache, including promising recent results of randomized controlled trials studying sphenopalatine ganglion stimulation, trigeminal nerve stimulation, transcutaneous vagus nerve stimulation, and transcranial magnetic stimulation. Finally, we discuss patch, inhaled, and intranasal methods of triptan and dihydroergotamine delivery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bigal ME, Walter S, Rapoport AM (2013) Calcitonin gene-related peptide (CGRP) and migraine current understanding and state of development. Headache 53:1230–1244

    PubMed  Google Scholar 

  2. Ho TW, Connor KM, Zhang Y et al (2014) Randomized controlled trial of the CGRP receptor antagonist telcagepant for migraine prevention. Neurology 83:958–966

    Article  CAS  PubMed  Google Scholar 

  3. Dodick D, Goadsby P, Spierings E et al (2014) Safety and efficacy of LY2951742, a monoclonal antibody to calcitonin gene-related peptide, for the prevention of migraine: a phase 2, randomised, double-blind, placebo-controlled study. Lancet Neurol 13:885–892

    CAS  PubMed  Google Scholar 

  4. Dodick D, Goadsby P, Silberstein S et al (2014) Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine: a randomised, double-blind, placebo-controlled, exploratory phase 2 trial. Lancet Neurol 13:1100–1107

    CAS  PubMed  Google Scholar 

  5. Goldstein DJ, Roon KI, Offen WW et al (2001) Selective serotonin 1F (5-HT(1F)) receptor agonist LY334370 for acute migraine: a randomised controlled trial. Lancet 358:1230–1234

    CAS  PubMed  Google Scholar 

  6. Farkkila M, Diener HC, Geraud G et al (2012) Efficacy and tolerability of lasmiditan, an oral 5-HT(1F) receptor agonist, for the acute treatment of migraine: a phase 2 randomised, placebo-controlled, parallel-group, dose-ranging study. Lancet Neurol 11:405–413

    PubMed  Google Scholar 

  7. Schoenen J, Jensen RH, Lanteri-Minet M et al (2013) Stimulation of the sphenopalatine ganglion (SPG) for cluster headache treatment. Pathway CH-1: a randomized, sham-controlled study. Cephalalgia 33:816–830

    Article  PubMed Central  PubMed  Google Scholar 

  8. Schoenen J, Vandersmissen B, Jeangette S et al (2013) Migraine prevention with a supraorbital transcutaneous stimulator: a randomized controlled trial. Neurology 80:697–704

    Article  PubMed  Google Scholar 

  9. Gaul C, Diener H, Solbach K (2014) Non-invasive vagus nerve stimulation Using gammaCore for the prevention and acute treatment of chronic cluster headache: report from the randomised phase of the PREVA Study. In: 4th European Headache and Migraine Trust International Congress. Copenhagen, Denmark

  10. Goadsby PJ, Grosberg BM, Mauskop A et al (2014) Effect of noninvasive vagus nerve stimulation on acute migraine: an open-label pilot study. Cephalalgia 34:986–993

    Article  CAS  PubMed  Google Scholar 

  11. Silberstein SD, Da Silva AN, Calhoun AH et al (2014) Non-invasive vagus nerve stimulation for chronic migraine prevention in a prospective, randomized, sham-controlled pilot study (the EVENT study): report from the double-blind phase. 56th Annual Scientific Meeting of the American Headache Society, Los Angeles

  12. Fontaine D, Vandersteen C, Magis D et al (2015) Adv Tech Stand Neurosurg 42:3–21

    Article  PubMed  Google Scholar 

  13. Saper JR, Dodick DW, Silberstein SD et al (2011) Occipital nerve stimulation for the treatment of intractable chronic migraine headache: ONSTIM feasibility study. Cephalalgia 31:271–285

    Article  PubMed Central  PubMed  Google Scholar 

  14. Lipton RB, Dodick DW, Silberstein SD et al (2010) Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial. Lancet Neurol 9:373–380

    PubMed  Google Scholar 

  15. Goldstein J, Smith T, Pugach N et al (2012) A sumatriptan iontophoretic transdermal system for the acute treatment of migraine. Headache 52:1402–1410

    PubMed  Google Scholar 

  16. Aurora S, Silberstein S, Kori S et al (2011) MAP0004, orally inhaled DHE: a randomized, controlled study in the acute treatment of migraine. Headache 51:507–517

    PubMed  Google Scholar 

  17. Cady R, McAllister P, Spierings E et al (2015) A randomized, double-blind, placebo-controlled study of breath powered nasal delivery of sumatriptan powder (AVP-825) in the treatment of acute migraine (the TARGET study). Headache 55:88–100

    PubMed Central  PubMed  Google Scholar 

  18. Vollbracht S, Rapoport AM (2014) New treatments for headache. Neurol Sci 35(Suppl 1):89–97

    PubMed  Google Scholar 

Download references

Acknowledgments

Parts of this paper were adapted with permission from a previously published article written by authors Vollbracht and Rapoport [18].

Conflict of interest

N.M. Schuster and S. Vollbracht have no actual or potential conflicts of interest in relation to this article. A. Rapoport serves on the speaker’s bureau of Depomed and serves on the advisory board of Depomed, Doctor Reddy’s, Impax, Merck, Teva and Winston Laboratories Inc. He is an editor of CNS Drugs, Headache, and Neurology Reviews.

Author information

Authors and Affiliations

  1. Department of Neurology, Ronald Reagan-UCLA Medical Center, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Suite 1240, Los Angeles, CA, 90024, USA

    Nathaniel M. Schuster

  2. Department of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Sarah Vollbracht

  3. Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Alan M. Rapoport

Authors
  1. Nathaniel M. Schuster
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah Vollbracht
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alan M. Rapoport
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nathaniel M. Schuster.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schuster, N.M., Vollbracht, S. & Rapoport, A.M. Emerging treatments for the primary headache disorders. Neurol Sci 36 (Suppl 1), 109–113 (2015). https://doi.org/10.1007/s10072-015-2133-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-015-2133-1

Keywords

Search

Navigation