Are We Going To Win The War Against Migraine Soon?

^{We are all familiar with headaches, and most of the time, we use medications like acetaminophen or other types of strong pain relievers, and in the end, we are fine. However, there are a few people who suffer from a different kind of headache known as migraines, and these people will not define headache as simply as you would. Moreover, most of the migraine treatments available do not work for them.}

^{Migraines are neurological conditions where the person suffers episodes of severe headache, nausea, aura, brain fog, tiredness, and hypersensitivity to light, sound, and smell. Migraine treatments began in the early 1800s and it looks like it hasn't improved so much over time. In the early days of treating migraines, we used a whole lot of things that are regarded as poison now such as Arsenic and cyanide.}

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^{We wanted to treat this headache, so we turned to a lot of treatment options including using medications that were meant for other conditions such as using Tricyclic antidepressants and beta blockers. The first drug as it may sound was for depression while the other is for high blood pressure. These medications target message sending in the brain, turning down messages that are not helpful. These medications didn't work for everyone and came with side effects like depression, irregular heartbeat, and tiredness.}

^{At one time, we even sort treatment like Botox which is a toxin derived from the bacteria botulinum and its toxin prevents nerves from communicating with the muscle, and the patients who suffered migraines were given the injection in places around the face, head, and neck where the migraine could occur. At the end, Botox doesn't work for everyone with migraine but it offers a decrease in symptoms for people who experience it for 15 days or more in a month.}

^{At some point, treating the physiological cause of migraine once and for all was the goal for scientists, and one suspect came to mind which was the blood vessel carrying blood in the head. Since there were no pain receptors in the brain, researchers suspected that blood flow to the head and at the time too much blood to the skull was the suspect and it was believed that too mucb blood i to rhe skull caused pressure which activated nerves around the region leading to pain in the membrane sorrounding the brain.}

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^{Medications like triptans were used to help reduce the blood flow in the blood vessels. This medication cannot prevent migraine but it can be used upon the first sign of a migraine allowing it to work properly. After triptan, scientists have learned that migraine could be more of a neurological problem and not a vascular problem.}

^{In the late 1990s and early 2000s, we decided to go for a protein named CGRP which is believed to be the cause of migraine as it is the protein that dilates blood vessels and alters pain receptors in the brain. So drugs like GEPANTS were made to target the CGRP protein. Gepants bind with the protein thereby reducing the number of proteins that would have caused the harm. Antibody treatment targeting CGRP was also used and this was effective as it cuts down the number of days to feel the headache, as well as showing signs of improvement in about 60% of people after treatments for about 3 months, and about 90% for people over 11 months of treatment.}

^{Combining medications is seen as another option to treat migraine since different drugs treat migraine in different ways with the majority targeting different pain pathways but then, we still need to look into lots of other treatment methods so we can find a lasting solution to migraines.}

^Reference

^{https://journals.sagepub.com/doi/10.1046/j.1468-2982.2002.00422.x
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https://www.imrpress.com/journal/JIN/19/1/10.31083/j.jin.2020.01.1240
https://www.neurology.org/doi/10.1212/WNL.0000000000002560
https://my.clevelandclinic.org/health/drugs/19457-amitriptyline-tablets
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