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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(12): 1084-1097
DOI: 10.1055/s-0043-1777723
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The history and rationale of the development of new drugs for migraine treatment

A história e os fundamentos do desenvolvimento de novos medicamentos para o tratamento da migrânea
Pedro André Kowacs 
1   Instituto de Neurologia de Curitiba, Serviço de Neurologia, Curitiba PR, Brazil.
2   Universidade Federal do Paraná, Complexo Hospital de Clínicas, Unidade do Sistema Nervoso, Curitiba PR, Brazil.
,
Pedro Augusto Sampaio Rocha-Filho 
3   Universidade Federal de Pernambuco, Centro de Ciências Médicas, Divisão de Neuropsiquiatria, Recife PE, Brazil.
4   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Clínica de Cefaleia, Recife PE, Brazil.
,
Mário Fernando Prieto Peres 
5   Universidade de São Paulo, Hospital das Clínicas, Instituto de Psiquiatria, São Paulo SP, Brazil.
,
Lars Edvinsson 
6   Lund University, Institute of Clinical Sciences, 22185 Lund, Sweden.
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Abstract

Migraine is one of the most prevalent and disabling diseases in the world. Migraine attack treatments and prophylactic treatments of this disease are essential to lessen its individual, social, and economic impact. This is a narrative review of the main drugs used for treating migraine, as well as the experimental models and the theoretical frameworks that led to their development. Ergot derivatives, triptans, non-steroid anti-inflammatory drugs, tricyclic antidepressants, beta-blockers, flunarizine, valproic acid, topiramate, onabotulinumtoxin A, ditans, monoclonal antibodies against CGRP and its receptor, and gepants are discussed. Possible therapeutic targets for the development of new drugs that are under development are also addressed. Many of the drugs currently in use for treating migraine were developed for the treatment of other diseases, but have proven effective for the treatment of migraine, expanding knowledge about the disease. With a better understanding of the pathophysiology of migraine, new drugs have been and continue to be developed specifically for the treatment of this disease.

Resumo

A migrânea é uma das doenças mais prevalentes e incapacitantes do mundo. O tratamento da crise de migrânea e o tratamento profilático da doença são essenciais para diminuir o seu impacto individual, social e econômico. Este é um artigo de revisão narrativa. Revisamos as principais drogas usadas para a migrânea e os modelos experimentais e referenciais teóricos que levaram ao seu desenvolvimento. Foram abordados os derivados do ergot, triptanas, anti-inflamatórios não hormonais, antidepressivos tricíclicos, betabloqueadores, flunarizina, ácido valproico, topiramato, toxina onabotulínica do tipo A, os ditans, anticorpos monoclonais contra o CGRP e seu receptor e os gepants. Também foram abordados possíveis alvos terapêuticos para o desenvolvimento de novas drogas e drogas que estão em desenvolvimento para o tratamento da migrânea. Muitas das drogas usadas atualmente foram desenvolvidas para o tratamento de outras doenças e se mostraram efetivas para o tratamento da migrânea. Essas ajudaram a ampliar o conhecimento sobre a doença. Com o melhor entendimento da fisiopatologia da migrânea, novas drogas foram e estão sendo desenvolvidas especificamente para o tratamento dessa doença.

Keywords

Headache - Migraine Disorders - Drug Development - Therapeutics - Pathophysiology

Palavras-chave

Cefaleia - Transtornos de Enxaqueca - Desenvolvimento de Medicamentos - Terapêutica - Fisiopatologia

Authors' Contributions

PAK: conceptualization, data curation, formal analysis, project administration, writing – original draft, writing – review & editing; PASRF: formal analysis, project administration, writing – original draft, writing – review & editing; MFPP, LE: formal analysis, writing – review & editing.




Publikationsverlauf

Eingereicht: 03. Oktober 2023

Angenommen: 21. November 2023

Artikel online veröffentlicht:
29. Dezember 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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