Migrane Headaches and Possible Drug Treatments Essay

Migrane Headaches and Possible Drug Treatments Essay

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Migraine headaches affect an estimated 36 million Americans, or about 12% of the population, surpassing asthma at 8.3% (25 million) and diabetes at 7.8% (23.6 million). Migraines are much more common in women than in men--about 3 times more common. Nearly 30% of women will experience at least one episode of migraine headaches in their lifetime, most commonly in the third and sixth decades of life. However, migraines can affect anyone at any age and from any ethnic group. In addition to indirect expenses like missed work/school and lost productivity, the American Migraine Foundation estimates that migraines cost Americans more than $20 billion annually. Migraine sufferers are also more likely to experience anxiety, depression, sleep disorders, fatigue, and other pain conditions, and those who experience visual disturbances called “auras” associated with migraines are at an increased risk of heart attack and stroke. Unfortunately, there is no cure for migraines. The best treatment options available only to seek to reduce frequency of attacks or treat an attack once one has begun, and medication use is often limited by side effects and difficulty of administration. The American Migraine Foundation itself labels current treatment options “far from perfect” and concludes, “Undoubtedly, better treatments are needed.” Filling this therapeutic void is the primary objective of NuPathe Inc. (very recently acquired by Teva Pharmaceutical Industries Ltd.) with Zecuity®, a sumatriptan iontophoretic transdermal system.

The exact mechanism of migraine headaches has not yet been elucidated. Gene studies, combined with the high correlation of family history with migraine susceptibility, give considerable evidence for a significant geneti...

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... concern with a fungus-based drug class called the ergotamine derivatives (e.g., dihydroergotamine), which also act as agonists at 5-HT receptors throughout the body and are much less specific than the triptans. Because of this potential for additive effects, administration of triptans and ergotamine derivatives should be separated by 24 hours. Lastly, overuse of acute migraine medications can lead to rebound headache symptoms known as “medication-overuse headache,” though the medications most commonly associated with this are opiates and analgesics, not triptans. Triptan-related medication-overuse headache is much more relegated to populations of men with high headache frequency. Nevertheless, it is still recommended for patients to restrict their intake of acute “rescue” migraine medication, including triptans, to 2 or 3 days per week to avoid rebound headache.

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