Acute and prophylactic treatment of migraine

2023 update

Authors

  • Sina Marzoughi, MD Division of Neurology, Department of Medicine, University of British Columbia
  • Sian Spacey, MBBS, FRCPC Division of Neurology, Department of Medicine, University of British Columbia

DOI:

https://doi.org/10.58931/cpct.2023.1216

Abstract

Migraine is a chronic neurological disorder that causes significant disability in patients and has a substantial economic impact in Canada. Effective treatment for migraine will improve our patients’ quality of life; additionally, it will reduce the economic burden generated by healthcare visits and employee absenteeism.

The novel treatments in migraine target calcitonin gene-related peptide (CGRP), a neuropeptide which plays a role in the initiation of a migraine attack. Although our current understanding of migraine pathophysiology is incomplete, it is believed to involve the trigeminal nerve and its connections with the cerebral vasculature with nociceptive signals activated through a variety of neuropeptides including CGRP, substance P and nitric oxide.

As a result of an improved understanding of migraine pathophysiology, the past several years have seen the advent of a variety of new therapeutic options in both the acute and prophylactic management of migraine. Although these agents represent additional options in the clinician’s arsenal, they have, in addition, introduced challenges in determining their cost-effectiveness. In this review, we provide an update on new acute and prophylactic migraine therapies and how they integrate into current practice from a primary care perspective.

Author Biographies

Sina Marzoughi, MD, Division of Neurology, Department of Medicine, University of British Columbia

Dr. Sina Marzoughi is an adult neurology resident at the University of British Columbia (UBC) where he serves as Chief Resident. He completed a Bachelor of Science, Honours in Neuroscience at the University of Alberta and medical school at the University of Calgary prior to moving to Vancouver, BC for his residency. He has won several research awards including the Barbara Allan 2021 Scholarship for his contributions in pain research as well as the Department of Medicine Ludmila & Henry Zeldowics Research award in 2022 for research productivity. Dr. Marzoughi has a strong interest in headache medicine as well as clinical research in headache. After his residency, he hopes to complete a clinical and research fellowship in headache medicine.

Sian Spacey, MBBS, FRCPC, Division of Neurology, Department of Medicine, University of British Columbia

Dr. Sian Spacey is a neurologist and Clinical Associate Professor in the Division of Neurology at UBC. She is Director of the UBC Headache Clinic, Director of the UBC Clinician Investigator Program, and is a past president of the Canadian Headache Society.

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Published

2023-06-14

How to Cite

1.
Marzoughi S, Spacey S. Acute and prophylactic treatment of migraine: 2023 update. Can Prim Care Today [Internet]. 2023 Jun. 14 [cited 2024 May 16];1(2):30–34. Available from: https://canadianprimarycaretoday.com/article/view/1-2-marzoughi_et_al

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Volume 1, Issue 2, June 2023

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