Characterization of 5-Hydroxytryptamine, adrenergic and CGRP receptors in relation to migraine

Migraine affects a substantial fraction of the world population and is a major cause of disability in the work place. Migraine is a recurrent incapacitating neurovascular disorder characterized by attacks of debilitating pain associated with photophobia, phonophobia, nausea and vomiting. Though the pathophysiology of migraine is still unclear, it is believed to be a neurovascular disorder. The drugs used in the treatment of migraine affect vascular receptors. In earlier days, α-adrenoceptors agonists (ergotamine, dihydroergotamine, isometheptene) where used. The last decade has witnessed the advent of sumatriptan and the ‘second generation triptans’, which belong to a class of drugs known as 5-HT1B/1D receptor agonists. The triptans have a well-established efficacy in aborting migraine attacks. Current prophylactic treatments for migraine include 5-HT2 receptor antagonists and β-adrenoceptor blockers. In view of the complexity of migraine etiology, the disease still remains under diagnosed, despite progress in migraine research and available therapies are underused. In this chapter, pharmacological targets, particularly those based on 5-HT, adrenergic and CGRP receptors, will be discussed in relation to migraine therapy.

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