Dr. Thomas Colletti
Headaches are common. The International Headache Society’s (IHS) International Classification of Headache Disorders, 3rd edition (ICHD 3), lists numerous primary headache disorders that primary care providers and even neurologists could find challenging to master. Migraine alone has thirteen subcategories demonstrating its heterogeneity. Despite this complex and sometimes overwhelming classification system, the good news is many pharmacotherapies are effective across multiple migraine phenotypes. Migraine is complex. This article seeks to provide a simplified description of migraine pathophysiology and its relation to targeted pharmacotherapeutics. Particular attention is paid to the serotonin receptor and its agonists (triptans and ditans), the calcitonin gene-related peptide, and various blockers (injectible monoclonal antibodies and oral gepants) newly available to combat migraine. Clinical analysis of migraine and its relation to headaches historically labeled as sinus headaches is touched upon, followed by vertiginous migraine and migraine in women.
Keywords: International Headache Society classification 3rd edition, migraine, migraine with aura, triptan, ditan, calcitonin gene-related peptide CGRP, gepant, sinus headache, vestibular migraine
Patt -Bogut MA. Migraine: Beyond the headache. A brief review of pathophysiology and targeted pharmaco-therapeutics. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(2).
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