Migraine is the most common headache tye seen in clinical practice. Fortunately, significant advances in our understanding of the process of migraine have led to improved treatment paradigms. The major advance in the management of the acute migraine attack has been in the development of triptan medications which target selected serotonin receptors and treat the process of migraine, rather than just its symptoms. The triptans are highly effective and have significantly broadened the treatment options for migraine sufferers. Altough a breakthrough, triptans are not effective for all migraine sufferers. In addition, the triptans have inherent vasoconstrictor effects which, altough infrequently seen when used in appropriate clinical settings., limit their utility in certain patient populations. In order to broaden treatment options for patients with migraine, several therapeutic targets have been identified. With a greater understanding of the role of calcitonin gene related peptide (CGRP) in the process of migraine, CGRP antagonists have been identified as potential targets for acute migraine therapy.

Advances in our understanding of how to integrate pharmacological interventions as part of a comprehensive treatment plan for migraine sufferers can make this disabling headache disorder a highly manageable condition for most suferers.

After completing this activity, participants should be better able to:

• Understand current concepts of migraine pathophysiology and recognize the role of CGRP in migraine
• Recognize common clinical presentations for migraine
• Identify treatment strategies for managing the acute attack of migraine
• Understand the role of behavioral and pharmacological preventive approaches for migraine

Any practitioner who manages patients with headache.

Curtis P. Schreiber, MD
Associate Director, Headche Care Center
Springfield, MO

Julie A. Bumham, DO
Clinical Associate Professor
Michigan State University College of Osteopathic Medicine
Private Practice, Michigan Neurology, PLLC
Mt. Clemens, MI

Eric J. Eross, DO
Director, Scottsdale Headche Center
at Arizona Neurological Institute
Scottsdale, AZ
Assistant Clinical Professor, AZCOM
Glendale, AZ
 

Dr. Schreiber has been a primary or secondary investigator for research studies funded by Abbott, Advanced Bionics, Alexza, AMDC, Allergan, Alizyme, BioAlliance, GlaxoSmithKline, Jazz Pharmaceuticals, King, MAP, Merck&Co., Minster Pharmaceuticals, Neuralieve, Novartis, Ortho-McNeil, Pfizer, Schwarz Biosciences, Torrey Pines Therapeutics, and Zogenix

Dr. Bumham is on the speaker's bureau and is a consultant for Biogen and GlaxoSmithKline.

Dr. Eross is a consultant for Allergan. He is a speaker for Allergan, GlaxoSmithKline, Merck, Ortho-McNeil, and Pfizer; and he has received grants for research from Merck and Neuralieve.

This program is supported through an educational grant from Merck & Co., Inc.

This activity was developed from a symposia delivered at the 2007 AOA/ACOFP 112th Annual Convention in San Diego on September 30, 2007.

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During this activity, authors may discuss an unlabeled use or an investigational use not approved for a commercial product. Each author is required to disclose this information to the participants when referring to an unlabeled or investigational use.

Dr. Schreiber will discuss new potential targets for migraine therapy including CGRP regulator antagonists: and Dr. Bumham will discuss off label use of medication for migraine treatment.