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Cyproheptadine, sold under the brand name Periactin among others, is a first-generation antihistamine with additional anticholinergic, antiserotonergic, and local anesthetic properties. It was patented in 1959 and came into medical use in 1961. [ 5 ]
The drugs are started at a low dose, which is gradually increased until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or side effects become intolerable. Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. [13]
Rescue treatment involves acute symptomatic control with medication. [4] Recommendations for rescue therapy of migraine include: (1) migraine-specific agents such as triptans, CGRP antagonists, or ditans for patients with severe headaches or for headaches that respond poorly to analgesics, (2) non-oral (typically nasal or injection) route of administration for patients with vomiting, (3) avoid ...
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Pizotifen is able to dose-dependently and fully antagonize the discriminative stimulus effects of the serotonin–norepinephrine–dopamine releasing agent and serotonin 5-HT 2 receptor agonist MDMA in rodent drug discrimination tests. [10] Conversely, the related drug cyproheptadine was only partially effective and clozapine was ineffective. [10]
Cyproheptadine blocks 5-HT 2A, H1 and is a mild anticholinergic. Methysergide is a 5-HT 2A antagonist and nonselective 5-HT 1 receptor blocker. It causes retroperitoneal fibrosis and mediastinal fibrosis. [citation needed] Quetiapine blocks 5-HT 2A, 5-HT 1A, dopamine receptors D 1 and D 2, histamine receptor H1, and A1 adrenoreceptors.
The ICHD-2 specifies two different forms of the previously dubbed "menstrual migraine": pure menstrual migraine without aura and menstrually-related migraine without aura. The sole difference between these diagnoses is the occurrence of headache attacks outside of the 5-day period described in the diagnostic criteria.
Examples of specific antimigraine drug classes include triptans (first line option), ergot alkaloids, ditans and gepants. Migraines can also be treated with unspecific analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. Opioids are not recommended for treatment of migraines.
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