New Remedies Against Migraine

Very soon, new medicines specifically for migraine will arrive on the Swiss market. Update on the range of therapeutic solutions.

Migraine, a very common disease that affects 10 to 15% of the population.

Most sufferers only face these ailments once or twice a month, while in a minority, migraine attacks occur more regularly and handicap the daily life.

Migraine is not a common headache. It is defined according to strict characteristics. Indeed, for the diagnosis to be made, at least two of the following four criteria must be met: the pain begins on one side (right or left) of the head; it is pulsatile, as if one were hammering; its intensity is moderate to severe (from 5/10 to 10/10 on the pain scale); it obliges to stop the activity in progress or, failing that, is reinforced if the activity is continued. In addition, it must be accompanied by at least one of the following symptoms: vomiting or nausea, or discomfort felt by light and noise.

Establish the diagnosis
If you have already experienced these symptoms, be aware that effective treatments exist and that new drugs will soon arrive on the market. But above all, during the consultation, the doctor will try to understand when the crises occur. On the basis of migraine, several elements can indeed promote the appearance of a migraine. This is the case for some drinks (white wine would be typical), certain foods, lack of sleep, odors, prolonged time in front of screens, the arrival of the weekend, etc .: “The triggering factors are very diverse and very individual. It’s about identifying them with the patient. The action on these elements is an integral part of the care, “says neurology professor Philippe Ryvlin, head of the department of clinical neuroscience at the Vaud University Hospital Center (CHUV).

Medically, we will begin first with the timely treatment of seizures. In the first line, conventional painkillers (paracetamol or anti-inflammatory) will be prescribed. If they fail to reduce the pain, the doctor will offer “triptans”, another class of drugs. The latter reduce the dilation of the blood vessels, in particular by stimulating serotonin receptors, and moreover have an effect on the circuits of pain. “They are overall more effective at stopping the crisis, they reduce the intensity of the pain and act more quickly. But they are more expensive and less well tolerated than standard analgesics, “says Professor Ryvlin.

If episodes of migraine are too frequent and their punctual treatment appears to be insufficient, a background treatment, to avoid their occurrence, will be proposed. The doctor has here several types of drugs that have an effectiveness against migraine, but are not necessarily specific to treat this disorder. Among them, some beta-blockers, used against hypertension or heart disease.

The discovery of their preventive effect against migraines is empirical, and does not rely on a well-established mechanism. Some antiepileptics and antidepressants have also been shown to be useful in spacing and reducing the intensity of migraine episodes. “The choice between any of the available medications depends on the individual characteristics (gender, age, other treatments) and their risk of side effects. We are not going to prescribe antihypertensives for a young woman with low blood pressure, “says Professor Ryvlin.

Although some painkillers are available over-the-counter, such as paracetamol and ibuprofen, they should be used with caution. Taking these medications too often can make the pain worse. Paradoxically, headaches become more frequent, even chronic. It is considered that more than two intakes of analgesics per week over a period of three months are already an abuse.

But for patients who respond poorly to these treatments due to persistent pain or frequent crises, or for those who do not bear the side effects, the arrival of a new class of drugs is a real hope.

Unlike drugs used in the treatment of the background, “anti-CGRP” have been specifically developed against migraine disorders. ”  The CGRP peptide antagonists are the result of research on the mechanisms of migraine.

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