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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Fresh Research - The "Post-Triptan Era"
        
(Message started by: floridian on Sep 14^th, 2004, 9:00am)

Title: Fresh Research - The "Post-Triptan Era"
Post by floridian on Sep 14^th, 2004, 9:00am

Dr. Goadsby says he sees the end of triptans as the mainstay abortive - CGRP inhibitors have been proven for migraines, and are presumed to have the same effect for clusters. He mentions some other possible mechanisms, including nociceptin, vanilloids (capsaicin/substance P) and adenosine receptors. The cat is not in the bag yet, but is curiously approaching and the strings will be pulled at the appropriate moment. This will take time, but optimism is in order.

Quote:

Curr Pain Headache Rep. 2004 Oct;8(5):393-8.

Post-triptan Era for the Treatment of Acute Migraine.

Goadsby PJ.

There now is one realized and several attractive targets for the treatment of acute attacks of migraine that will follow and augment the use of serotonin 5-HT(1B/1D) receptor agonists, the triptans. Calcitonin gene-related peptide (CGRP) receptor blockade recently has been shown to be an effective acute antimigraine strategy; therefore, blockade of CGRP release by inhibition of trigeminal nerves would seem a logical approach. A number of targets are reviewed in this article including serotonin 5-HT(1F) and 5-HT(1D) receptors, adenosine A1 receptors, nociceptin, vanilloid TRPV1 receptors, and anandamide CB(1) receptors. Development of one or more such compound offers the exciting prospect of new non-vasoconstrictor treatments for migraine and cluster headache.

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by ozzy on Sep 14^th, 2004, 9:12am

Let's all say Yay!! Cheers! Salud!! Na zdorovje!!

Closer and closer relief at hand, can't wait!

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Renee on Sep 14^th, 2004, 10:57am

I saw a new neuro yesterday that Dr. Sheftell at NECH sent me to, more locally, to help with rescues and he gave me 4000 i.u. of Keppra via IV. It is an IV compound he has a pharmacist make up for him since Keppra only comes in capsule form.

The kip 8 was down to a kip 4 within the first 2 IV injections. At 3000 i.u. I was totally pain free with no narcotics, nausea or anything except for some relaxation and drowsiness. Keppra is in the same family type as Zonegran and the other anti-seizure meds used for clusters. It is nice to find an alternative to the narcotics, thus less side effects.

He also gave me an RX for 6 of the Actiq, the fentanyl lollipop, for severe breakthoughs instead of having to run to the e.r. I have had success with Fentanyl and Reglan via IV so I'm gonna try the Actiq with a Reglan pill and see if I can avoid the e.r. altogether when having those severe breakthroughs. If during the daytime hours and prior to 7 pm I can go to his office and he will give me another IV of Keppra for rescue.

He told me if I know of any other cluster sufferers in the D/FW metro area that need something better or other than triptan or a rescue other than the e.r., and is interested in the Keppra IV, to have them contact me for his information. He will be in London next week with Dr. Sheftell at a migraine summit though.

Renee

edited to add content

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Lizzie2 on Sep 14^th, 2004, 11:21am

Which drugs are the CGRP inhibitors? I can't remember. The article says proven effective for migraine which means I've probably tried it at some point. If it's worth it, I'll try it again!

Lizzie

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by unsolved1 on Sep 14^th, 2004, 11:43am

KEPPRA .... YIKES !!!

I'm glad it helped you ... BUT .....

Keppra was one of the worst drug experiences that I have ever had. Constant nightmares. Over and over. It was totally insane ! That stuff can really mess with your brain !!

I'll never do Keppra again !

Unsolved

Title: Re: Fresh Research - The "Post-Triptan Era&am
Post by floridian on Sep 14^th, 2004, 12:40pm

on 09/14/04 at 11:21:23, Lizzie2 wrote:

Which drugs are the CGRP inhibitors? I can't remember. The article says proven effective for migraine which means I've probably tried it at some point. If it's worth it, I'll try it again!

Lizzie

The CGRP inhibitors are still experimental - they have been proven effective in preliminary studies, but have not gone through the entire process to get government approval. Most of them have a number like BIBN4096BS - I'm sure a highly paid team of advertising psychologists is working on a name as they move the drug towards market. [smiley=hammer.gif]

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Tom K on Sep 14^th, 2004, 12:57pm

I'm all over these when they come out. Any name suggestions?

Beasttamer?
Not Viagra?
Gee, my head doesn't hurt anymore?
Clusterforia?

I know, stupid but trying to get through the day.

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by nancyc on Sep 14^th, 2004, 1:27pm

Glad you got some relief, Renee...And glad to see we have some neuros out there putting their "thinking caps" on for us sufferers! My neuro wants me to write a paper for him on some theories I have come up with my chs..LMAO...hope he has spellcheck :Dnancyc

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Renee on Sep 14^th, 2004, 2:32pm

Unsolved,

Did you get Keppra via IV? I got a one time IV dose of 4000 i.u.

I got somewhat drowsy and came home and took a nap but when bedtime came I kept waking up like every 20 min. for no reason at all. I finally took 5mg Ambien at 2 am and still kept waking up. Finally got up at 4 am and hit the coffee pot. Still no sleep AND no clusters or shadows, just drowsy feeling.

If I ever get to sleep and have any nightmares, I will let ya know.

Yawn....
Renee

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Rock_Lobster on Sep 14^th, 2004, 10:24pm

Heh heh... CGRP inhibitors... right about the time that Imitrex goes generic.

Looking forward to more on that. Thanks Floridian!

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by pubgirl on Sep 15^th, 2004, 4:04am

Thanks Jonathan

While I was surfing (thanks to MOB for the name of the drug in development- BIBN4046 BS) I found a lot of VERY interesting stuff about where the different new drugs are at, but in addition came across this:

http://www.future-drugs.com/Iparticle.asp?publicationid=4&articleid=1033

It's not new and may have been posted before but it has great summaries of all the info I need to be aware of (couple of slight points we could be critical of but not much)

It's a keeper for those of you who store links!

Wendy

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by clarence on Sep 15^th, 2004, 4:57am

That looks like a pretty good article Wendy. Thanks for the link.

Casey

Title: Re: Fresh Research - The "Post-Triptan Era&qu
Post by Rock_Lobster on Sep 15^th, 2004, 9:05am

Yes... future-drugs.com is a great site. If you have not seen it, check out this CH-specific document...

http://www.future-drugs.com/admin/articlefile/ERN020304.pdf

Title: Re: Fresh Research - The "Post-Triptan Era&am
Post by floridian on Sep 15^th, 2004, 9:06am

on 09/14/04 at 22:24:32, Rock_Lobster wrote:

Heh heh... CGRP inhibitors... right about the time that Imitrex goes generic.

There's plenty of room for suspicion when it comes to patents. But there are natural CGRP inhibitors as well - I don't think they can totally corner the market on this.