PHRM 211 Lecture 17: NEUR Pharmacology of Headaches (Part 2)
Document Summary
Lasmitidan (ly573144) acts selectively at 5ht1f receptor. Recommended when the patient experiences 3 migraine attacks/month . 3 fundamental obstacles faced are the lack of knowledge about how , when , where (in the brain) a migraine attack starts. Central component (including descending facilitation leading to central sensitization) Proven effective as prophylactic treatment for migraine in rcts with level a evidence. Other aeds (gabapentinoids, lamotrigine, oxcarbazepine and vigabatrin) have been tested mainly without success. Tonabersat inhibits csd, may prevent migraine aura ( not yet approved in canada ) Rcts have been tried for a variety of glutamate antagonists without clinical success. Glutamate receptor antagonist adx-10059 failed clinical trials due to cases of elevated liver functions. Moa : block reuptake of monoamine serotonin and noradrenaline. Onset of action : complex, within a few days with low dose (10 mg) Drowsiness (h1, alpha and anticholinergic blockade in the brain) useful in. Side effects ( less for nortriptyline): migraineurs with insomnia.
