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Title of Journal: Neurol Sci

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Abbravation: Neurological Sciences

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Springer Milan

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1590-3478

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The therapeutic future in headache

Authors: Alan M Rapoport
Publish Date: 2012/05/30
Volume: 33, Issue: 1, Pages: 119-125
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Abstract

There are many categories and individual types of headache and most have a variety of treatment protocols while a few are best treated by just one medication This paper will concentrate on acute care medications for migraine and discuss some new and future acute care treatments There is not much to discuss about prevention except that onabotulinumtoxinA has been approved for prevention of chronic migraine Cluster headache will also be discussed as there are some future treatments for acute care and prevention being studied at present For the acute care of migraine in the US we have seven triptans by tablet plus other routes and one non steroidal antiinflammatory medication approved by the FDA that is currently available Cambia brand of buffered diclofenac potassium for oral solution There are several other acute care medications in various stages of development and there are three new methods of administering a triptan and others under investigation The optimal acute care therapy for migraine should be faster easier to use and more efficient with fewer adverse events than what is currently available What follows is a brief review of the status in development for five of the many new acute care medications being investigated the CGRP antagonist tablet telcagepant the sumatriptan iontophoretic patch Zelrix sumatriptan powder for use in the OptiNose apparatus dihydroergotamine for oral inhalation Levadex civamide nasal solution for prevention of episodic cluster headache Civanex and sphenopalatine ganglion stimulation for acute cluster attacks in chronic cluster headaches Other future treatments that will not be discussed include transcranial magnetic stimulation a 5HT1F agonist named alniditan large conductance calciumactivated potassium channel openers glial modulators or other medications and devices in early stages of development

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