Migraine
Sequence:
- Trigger 2a. Serotoninergic neurons release serotonin 5-HT 2a. Noradrenergic neurons release norephedrine aka noradrenaline (NA) (whose precursor is Dopamine)
- Vasoconstricion & inflammation
- Trigeminal nerve releases CGRP
- Vasodilatation
Hence there's a correlation b/w migraine and the release of:
- Serotonin 5-HT
- CGRP
- Dopamine / NA
CGRP - Calcitonine gene related peptide
- Increased level of this peptide are found during migraines
- Released by trigeminal nerve. Produced by neurons.
- Vasodilatator
Drugs
CRGP antagonis: Gepant
- most promising rimegepant - Nurtec
- risk of liver toxicity
Serotonin Antagonist - Triptans
Antagonist for serotonin receptors