Migraine with Different Phases and Various Therapies Used to Treat Migraine

Migraine is a complex neurovascular headache disorder characterized by moderate to severe headache episodes, often accompanied by symptoms like phonophobia, nausea, and vomiting.The biology of migraine involves genetic predisposition, environmental factors, and sensory brain processing.Episodic migraine (EM) occurs fewer than 15 headache days per month, while chronic migraine (CM) occurs 15 or more days per month.CM usually develops from EM with a yearly advancement rate of 3%, and risk factors include high baseline frequency of EM attacks, acute drug overuse, and comorbid mental illnesses.Migraines affect relationships, work, financial well-being, and physical and mental health.Pathophysiology involves activation of the trigemino-vascular system and hypothalamic involvement.Treatment aims to improve patient function, with options like triptans, ditans, gepants, ergot alkaloids, NSAIDs, and analgesics.Triptans, developed in the 1990s, work by activating serotonin receptors, while ditans like lasmiditan target 5-HT1F receptors.Gepants, such as ubrogepant, are CGRP receptor antagonists.Ergot alkaloids, like dihydroergotamine, have been used since the 1920s and work as non-specific 5-HT1 receptor agonists.Understanding these mechanisms can help develop targeted therapies for migraine treatment.