Skip to main content

Advertisement

Log in

Prophylactic migraine therapy: Emerging treatment options

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

In this paper, new treatment options for migraine prevention are reviewed. An overview about migraine pathophysiology is provided and current indications for migraine prevention and new and upcoming preventive medications are discussed briefly. Data are presented on topiramate, levetiracetam, zonisamide, botulinim toxin, tizanidine, nefazodone, lisinopril, candesartan, carabersat, petasites, and coenzyme Q.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Scher AI, Stewart WF, Lipton RB: Migraine and headache: a meta-analytic approach. In Epidemiology of Pain. Edited by Crombie IK. Seattle: IASP Press; 1999:159–170.

    Google Scholar 

  2. Stewart WF, Shechter A, Lipton RB: Migraine heterogeneity: disability, pain intensity, and attack frequency and duration. Neurology 1994, 44(suppl.4):24–39.

    Google Scholar 

  3. Lipton RB, Hamelsky SW, Stewart WF: Epidemiology and impact of migraine. In Wolff’s Headache and Other Head Pain. Edited by Silberstein SD, Lipton RB, Dalessio DJ. New York: Oxford University Press; 2001:85–107.

    Google Scholar 

  4. Lipton RB, Stewart WF, Simon D: Medical consultation for migraine: results from the American Migraine Study. Headache 1998, 38:87–96.

    Article  PubMed  CAS  Google Scholar 

  5. Stang PE, Von Korff M: The diagnosis of headache in primary care: factors in the agreement of clinical and standardized diagnoses. Headache 1994, 34:138–142.

    Article  PubMed  CAS  Google Scholar 

  6. Goadsby PJ: Pathophysiology of headache. In Wolff’s Headache and Other Head Pain, edn 7. Edited by Silberstein SD, Lipton RB, Dalessio DJ. Oxford: Oxford University Press; 2001:57–72.

    Google Scholar 

  7. May A, Goadsby PJ: The trigeminovascular system in humans: pathophysiologic implications for primary headache syndromes of the neural influences on the cerebral circulation. J Cereb Blood Flow Metab 1999, 19:115–127. Review of the pathophisiology of migraine.

    Article  PubMed  CAS  Google Scholar 

  8. Weiller C, May A, Limmroth V, et al.: Brain stem activation in spontaneous human migraine attacks. Nat Med 1995, 1:658–660.

    Article  PubMed  CAS  Google Scholar 

  9. Welch KM, Barkley GL, Tepley N, et al.: Central neurogenic mechanisms of migraine. Neurology 1993, 43:S21-S25.

    PubMed  CAS  Google Scholar 

  10. Van Harreveld A: The nature of chick’s magnesium-sensitive retinal spreading depression. J Neurobiol 1984, 15:333–344.

    Article  PubMed  Google Scholar 

  11. Schaumburg HH, Byck R, Gersti R, Mashman JN: Monosodium L-glutamate: its pharmacology and role in the Chinese restaurant syndrome. Science 1969, 163:826–828.

    Article  PubMed  CAS  Google Scholar 

  12. Ferrari MD, Odink K, Bos KD, et al.: Neuroexcitatory plasma amino acids are elevated in migraine. Neurology 1990, 40:1582–1586.

    PubMed  CAS  Google Scholar 

  13. Cananzi AR, D’Andrea G, Perini F, et al.: Platelet and plasma levels of glutamate and glutamine in migraine with and without aura. Cephalalgia 1995, 15:132–135.

    Article  PubMed  CAS  Google Scholar 

  14. Gallai V, Alberti A, Gallai B, et al.: Glutamate and nitric oxide pathway in chronic daily headache: evidence from cerebrospinal fluid. Cephalalgia 2003, 23:166–174.

    Article  PubMed  CAS  Google Scholar 

  15. Welch KM, Chabi E, Bartosh K, et al.: Cerebrospinal fluid gamma aminobutyric acid levels in migraine. Br Med J 1975, 3:516–517.

    PubMed  CAS  Google Scholar 

  16. Storer RJ, Akerman S, Goadsby PJ: GABA receptors modulate trigeminovascular nociceptive neurotransmission in the trigeminocervical complex. Br J Pharmacol 2001, 134:896–904.

    Article  PubMed  CAS  Google Scholar 

  17. Goadsby PJ, Lipton RB, Ferrari MD: Migraine: current understanding and treatment. N Engl J Med 2002, 346:257–270.

    Article  PubMed  CAS  Google Scholar 

  18. Goadsby PJ, Olesen J: Diagnosis and management of migraine. BMJ 1996, 312:1279–1288.

    PubMed  CAS  Google Scholar 

  19. Matchar DB, Young WB, Rosenberg J, et al.: Multispecialty consensus on diagnosis and treatment of headache: pharmacological management of acute attacks. Neurology 2000, 54: www.aan.com/public/practiceguidelines/03.pdf.

  20. Silberstein SD, Rosenberg J: Multispecialty consensus on diagnosis and treatment of headache. Neurology 2000, 54:1553.

    PubMed  CAS  Google Scholar 

  21. Silberstein SD, Goadsby PJ: Migraine: a preventive treatment. Cephalalgia 2002, 22:491–512. Extensive evidence-based review on current migraine preventive medications.

    Article  PubMed  CAS  Google Scholar 

  22. Smith L, Price-Jones M, Hughes K, et al.: Effects of topiramate on kainate- and domoate-activated [14C]guanidinium ion flux through GluR6 channels in transfected BHK cells using Cytostar-T scintillating microplates. Epilepsia 2000, 41(suppl 1):S48-S51.

    Article  PubMed  CAS  Google Scholar 

  23. Garnett WR: Clinical pharmacology of topiramate: a review. Epilepsia 2000, 41(suppl 1):S61-S65.

    Article  PubMed  CAS  Google Scholar 

  24. Topamax package insert. Raritan, NJ: Ortho-McNeil Pharmaceutical, Inc; 2002.

  25. Shuaib A, Ahmed F, Muratoglu M, et al.: Topiramate in migraine prophylaxis: a pilot study [Abstract]. Cephalalgia 1999, 19:379–380.

    Google Scholar 

  26. Edwards KR, Glautz MJ, Shea P: Topiramate for migraine prophylaxis: a double-blind, randomized, placebocontrolled study [Abstract]. Headache 2000, 40:407.

    Google Scholar 

  27. Potter DL, Hart DE, Calder CS, et al.: A double-blind, randomized, placebo-controlled, parallel study to determine the efficacy of topiramate in the prophylactic treatment of migraine [Abstract]. Neurology 2000, 54(suppl 3):A15.

    Google Scholar 

  28. Silberstein SD, Karin R, Jordan D, Hulihan J: Poster presented at the 14th Migraine Trust International Symposium. London: September 23–26, 2002.

  29. Brandes JL, Saper JR, Diamond M, et al.: MIGR-002 Study Group. Topiramate for migraine prevention: a randomized controlled trial. JAMA 2004, 291:965–973. One of the largest preventive clinical trials to date.

    Article  PubMed  CAS  Google Scholar 

  30. Banta JT, Hoffman K, Budenz DL, et al.: Presumed topiramateinduced bilateral acute angle-closure glaucoma. Am J Ophtalmol 2001, 132:112–114.

    Article  CAS  Google Scholar 

  31. Jones MW: Topiramate: safety and tolerability. Can J Neurol Sci 1998, 25:13–15.

    Google Scholar 

  32. Krusz JC: Levetiracetam as prophylaxis for resistant headaches [Abstract]. Cephalalgia 2001, 21:373.

    Google Scholar 

  33. Drake ME, Greathouse NI, Armentbright AD, Renner JB: Levetiracetam for preventive treatment of migraine [Abstract]. Cephalalgia 2001, 21:373.

    Google Scholar 

  34. Rapoport AM, Sheftell FD, Tepper SJ, Bigal ME: Levetiracetam in the preventive treatment of transformed migraine [Abstract]. Headache 2004, in press.

  35. Drake ME, Greathouse NI, Armentbright AD, Renner JB: Preventive treatment of migraine with zonisamide [Abstract]. Cephalalgia 2001, 21:374.

    Google Scholar 

  36. Krusz JC: Zonisamide in the treatment of headache disorders [Abstract]. Cephalalgia 2001, 21:374–375.

    Google Scholar 

  37. Binder WJ, Brin MF, Blitzer A, et al.: Botulinum toxin type A (Botox) for the treatment of migraine headaches: an openlabel study. Otolaryngol Head Neck Surg 2000, 123:669–676.

    Article  PubMed  CAS  Google Scholar 

  38. Zwart JA, Bovim G, Sand T, Sjaastad O: Tension headache: botulinum toxin paralysis of temporal muscles. Headache 1994, 34:458–462.

    Article  PubMed  CAS  Google Scholar 

  39. Relja MA: Treatment of tension-type headache by local injection of botulinum toxin. Eur J Neurol 1997, 4(suppl 2):71–72.

    Google Scholar 

  40. Durham PL, Cady R, Cady R: Regulation of calcitonin generelated peptide secretion from trigeminal nerve cells by botulinum toxin type A: implications for migraine therapy. Headache 2004, 44:35–43. This paper investigates the mechanism of action of botulinum toxin in migraine.

    Article  PubMed  Google Scholar 

  41. Silberstein S, Mathew N, Saper J, Jenkins S: Botulinum toxin type A as a migraine preventive treatment. For the BOTOX Migraine Clinical Research Group. Headache 2000, 40:445–450. Double-blind, placebo-controlled trial assessing the efficacy of botulinum toxin in the treatment of migraine.

    Article  PubMed  CAS  Google Scholar 

  42. Barrientos N, Chana P: Efficacy and safety of botulinum toxin type A (BOTOX®) in the prophylactic treatment of migraine [Abstract S106]. Presented at the American Headache Society 44th Annual Scientific Meeting. Seattle: June 21–23, 2002.

  43. Tepper SJ, Bigal ME, Sheftell FD, Rapoport AM: Botulinum toxin type a in the preventive treatment of refractory headache: a review of 100 consecutive cases. Headache 2004, in press.

  44. Ondo WG, Vuong KD, Derman HS: Botulinum toxin A (BOTOX®) for chronic daily headache: a randomized, placebo-controlled, parallel design study [Abstract S131]. Presented at the American Headache Society 44th Annual Scientific Meeting. Seattle: June 21–23, 2002.

  45. Blumenfeld AM, Binder W, Silberstein SD, Blitzer A: Procedures for administering botulinum toxin type A for migraine and tension-type headache. Headache 2003, 43:884–891.

    Article  PubMed  Google Scholar 

  46. Saper JR, Winner PK, Lake AE: An open-label dose-titration study of the efficacy and tolerability of tizanidine hydrochloride tablets in the prophylaxis of chronic daily headache. Headache 2001, 41:357–368.

    Article  PubMed  CAS  Google Scholar 

  47. Lake AE, Saper JR, Spiering EL, et al.: Chronic daily headache prophylaxis with tizanidine: a double-blind, multicenter, outcome study [Abstract]. Headache 2002, 42:430.

    Google Scholar 

  48. Saper JR, Lake AE, Tepper SJ: Nefazadone for chronic daily headache prophylaxis: an open-label study. Headache 2001, 111:465–474.

    Article  Google Scholar 

  49. Skidgel RA, Erdos EG: The broad substrate specificity of human angiotensin converting enzyme. Clin Exp Hypertens A 1987, 9:243–259.

    Article  PubMed  CAS  Google Scholar 

  50. Paterna S, DiPasquale P, D’Angelo A, et al.: Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura. Eur Neurol 2000, 43:133–136.

    Article  PubMed  CAS  Google Scholar 

  51. Tronvik E, Stovner LJ, Helde G, et al.: Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. JAMA 2003, 289:65–69.

    Article  PubMed  CAS  Google Scholar 

  52. Hovinga CA: Novel anticonvulsant medications in development. Expert Opin Ivestig Drugs 2002, 11:1387–1406.

    Article  CAS  Google Scholar 

  53. Parsons AA, Binghan S, Raval P, et al.: Tonabersat (SB-220453) a novel benzopyran with anticonvulsant properties attenuates trigeminal nerve-induced neurovascular reflexes. Br J Pharmacol 2001, 132:1549–1557.

    Article  PubMed  CAS  Google Scholar 

  54. Eaton J: Butterbur: herbal help for migraine. Natural Pharmacother 1998, 2:23–24.

    Google Scholar 

  55. Grossmann M, Schmidrams H: An extract of Petasites hybridus is effective in the prophylaxis of migraine. Int J Clin Pharmacol Ther 2000, 38:430–435.

    PubMed  CAS  Google Scholar 

  56. Lipton RB, Gobel H, Wilks K, et al.: Efficacy of petasites (an extract from Petasites rhizome) 50 and 75 mg for prophylaxis of migraine: results of a randomized, double-blind, placebo-controlled study [Abstract]. Neurology 2002, 58:A472.

    Google Scholar 

  57. Montagna P, Cortelli P, Barbiroli B: Magnetic resonance spectroscopy studies in migraine. Cephalalgia 1994, 14:184–193.

    Article  PubMed  CAS  Google Scholar 

  58. Bresolin N, Martinelli P, Barbiroli B, et al.: Muscle mitochondrial deletion and 31P NMR spectroscopy alterations in migraine patients. J Neurol Sci 1991, 104:182–189.

    Article  PubMed  CAS  Google Scholar 

  59. Rozen TD, Oshinsky ML, Gebeline CA, et al.: Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia 2002, 22:137–141.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bigal, M.E., Krymchantowski, A.V. & Rapoport, A.M. Prophylactic migraine therapy: Emerging treatment options. Current Science Inc 8, 178–184 (2004). https://doi.org/10.1007/s11916-004-0049-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-004-0049-1

Keywords

Navigation