Future Preventive Therapy: Are There Promising Drug Targets?

The primary headaches are among the most prevalent neurological disorders, afflicting up to 16% in Europe and 22% in USA of the adult population. The associated pain originates from intracranial blood vessels that are innervated by sensory nerves storing several neurotransmitters. In primary headaches, there is a clear association between the headache and the release of calcitonin gene-related peptide (CGRP) but not with other neuronal messengers. The specific purpose of this review is to describe the various anatomical aspects of neurotransmitters and mechanisms in the human cranial circulation and to elucidate a possible role for a specific agonist/antagonist in the treatment of primary headaches. Some of the drugs have emerged from laboratory science in the last decade, but most by coincidence when treating other disorders. The difference between an acute or a prophylactic antimigraine medication may simply reśide in the fact that the former includes an acute vasoconstrictor ability and has a shorter receptor binding time.