Migraine Research Paper
Migraine
1. Overview 2. Classes and Types of Migraine Headaches 3. Physiological Mechanism of Migraine 4. Serotonin System and Migraines 5. Antimigraine therapy
1. Overview
1
Migraine More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine.
Migraine is often misdiagnosed as sinus headache or tension-type headache.
Migraine (Con’t) Many factors can trigger migraine attacks: Alteration of sleep-wake cycle. Missing or delaying a meal. Medications that cause a swelling of the blood vessels. Daily or near daily use of medications …show more content…
Stress-> brain stem-> TGN-> thiamin-> Vasodilation of micro vessel s-> PAIN
Abnormal sensory modulation involving TGn Is critical in induction of migraine
5-HT plays an important role in the pathogenesis of migraine. Low 5-HT level is a key factor in migraine. Reduction of urinary and platelet 5-HT with elevations in 5-hydroxyindole acetic acid (5-HIAA) during migraine.
During migraine attacks Deficiency of central 5-HT …………………………..and probably a compensatory super-sensitivity of central 5-HT receptors (E.g. 5- HT1B receptors) …………………………….
The vasoconstriction role of 5-HT is mediated through 5-HT receptors (e.g. 5-HT1B receptors). 5-HT1B receptors are localized also in the endothelium
Of microvessels and mediate vasodilatory and contractile effects. ……………………………………………………………….
……………..
It is going to be on exam
Mechanism of actions of 5-HT receptors in migraine exam TRGP In meninges, 5-HT acts through 5-HT receptors to
Block the release of inflammatory chemical …………………………………………………
---->
In brainstem, 5-HT acts through 5-HT receptors to Block the pain impulses …………………………..and central brain perception Trigeminal nerve. via …show more content…
Measure …………….
O H3C N H S O N H CH3 N
Naratriptan
14
Treatment of Migraines
For prophylactic treatment of migraines Triptans not useful ……………………………….. ………………..
Prior to 2002, 5-HT2 receptor antagonists such as methysergide (Sansert®) were used to prevent Of frequent migraines recurrence …………………………….
Sansert® no longer available
Antimigraine Therapy
Adverse effects Cardiac effects include coronary artery vasospasm, transient myocardial ischemia and arrhythmias in patients with risk for coronary artery disease (contraindicated) Pain at site of s.c. injection for sumatriptan Oral administration results in paresthesia, asthenia and fatigue, flushing, pressure or tightness in chest, neck and jaw, drowsiness, dizziness, nausea, sweating
15
Antimigraine Therapy Triptans Contraindicated in patients with coronary artery disease, ischemia, or cerebrovascular disease Also contraindicated in patients taking MAO inhibitors
Other Treatments for Migraine
Ergotamine and caffeine Ergotamine first used in 1920s • Blocks norepinephrine reuptake and stimulates adrenergic
1. Overview 2. Classes and Types of Migraine Headaches 3. Physiological Mechanism of Migraine 4. Serotonin System and Migraines 5. Antimigraine therapy
1. Overview
1
Migraine More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine.
Migraine is often misdiagnosed as sinus headache or tension-type headache.
Migraine (Con’t) Many factors can trigger migraine attacks: Alteration of sleep-wake cycle. Missing or delaying a meal. Medications that cause a swelling of the blood vessels. Daily or near daily use of medications …show more content…
Stress-> brain stem-> TGN-> thiamin-> Vasodilation of micro vessel s-> PAIN
Abnormal sensory modulation involving TGn Is critical in induction of migraine
5-HT plays an important role in the pathogenesis of migraine. Low 5-HT level is a key factor in migraine. Reduction of urinary and platelet 5-HT with elevations in 5-hydroxyindole acetic acid (5-HIAA) during migraine.
During migraine attacks Deficiency of central 5-HT …………………………..and probably a compensatory super-sensitivity of central 5-HT receptors (E.g. 5- HT1B receptors) …………………………….
The vasoconstriction role of 5-HT is mediated through 5-HT receptors (e.g. 5-HT1B receptors). 5-HT1B receptors are localized also in the endothelium
Of microvessels and mediate vasodilatory and contractile effects. ……………………………………………………………….
……………..
It is going to be on exam
Mechanism of actions of 5-HT receptors in migraine exam TRGP In meninges, 5-HT acts through 5-HT receptors to
Block the release of inflammatory chemical …………………………………………………
---->
In brainstem, 5-HT acts through 5-HT receptors to Block the pain impulses …………………………..and central brain perception Trigeminal nerve. via …show more content…
Measure …………….
O H3C N H S O N H CH3 N
Naratriptan
14
Treatment of Migraines
For prophylactic treatment of migraines Triptans not useful ……………………………….. ………………..
Prior to 2002, 5-HT2 receptor antagonists such as methysergide (Sansert®) were used to prevent Of frequent migraines recurrence …………………………….
Sansert® no longer available
Antimigraine Therapy
Adverse effects Cardiac effects include coronary artery vasospasm, transient myocardial ischemia and arrhythmias in patients with risk for coronary artery disease (contraindicated) Pain at site of s.c. injection for sumatriptan Oral administration results in paresthesia, asthenia and fatigue, flushing, pressure or tightness in chest, neck and jaw, drowsiness, dizziness, nausea, sweating
15
Antimigraine Therapy Triptans Contraindicated in patients with coronary artery disease, ischemia, or cerebrovascular disease Also contraindicated in patients taking MAO inhibitors
Other Treatments for Migraine
Ergotamine and caffeine Ergotamine first used in 1920s • Blocks norepinephrine reuptake and stimulates adrenergic