Tatiana Murphy-Wheeler

What are CGRP antagonists, and how are they being used to treat migraines?

Started May 9, 2023

Abstract or project description

Migraine is a type of neurovascular headache disorder characterized by a unilateral, pulsating pain generally worsened by physical activity. Migraine symptoms are divided into prodromal symptoms and aura. Prodromal symptoms may include fatigue, mood changes, and frequent yawning all many hours before the onset of a headache. Aura, however, occurs shortly before onset and can involve visual disturbances, tremor, difficulty speaking, and other debilitating symptoms. It is theorized that the activation of hypothalamic neurons responsible for prodromal symptoms such as food craving and fatigue may stimulate neurons in the brain stem. This would then precipitate the release of substances promoting vasodilation and inflammation thus activating neurons associated with the trigeminal nerve and stimulating nociceptors in the meningeal layers surrounding the brain. That being said, this remains a theory, and there is still much to be explored and discovered surrounding the neurobiological causes and processes associated with migraine.

Migraines affect 1.1 billion people world wide in 2019, and this number continues to rise. Furthermore, many with migraines experience disabling pain which significantly lowers quality of life and increases rates of anxiety and depression. These people also have the financial burden of paying for care. In the US alone, the financial cost of migraines is estimated to be about $78 billion annually. The burden of chronic pain is not quantifiable; however, this data allows the scientific community a glimpse into the everyday struggle that those with migraine disorders experience.

With the ostensible urgency of such a widespread ailment lacking clear treatment, the introduction of CGRP antagonists as an unprecedentedly successful with limited side effects has become a topic of much discussion and excitement.