The number of migraine treatments and our understanding of migraine pathophysiology are both increasing. Newer treatments are focusing on migraine prevention. Botulinum toxin (BTX) is a potent neurotoxin that has been used primarily for diseases associated with increased muscle activity. Recently the toxin was found to have antinociceptive effects that are probably independent of its muscle-relaxant action. Recent clinical trials support the efficacy of BTX type-A (and possibly also type-B) in the treatment of migraine. The anticonvulsant topiramate was recently shown to be effective for migraine prevention. With the low doses used for this indication, cognitive side effects are less of a concern. Angiotensin (AT) II receptor blockade is a new approach to migraine prevention that was recently examined. The high tolerability of the AT1 receptor blocker candesartan warrants further studies to assess its role in migraine prevention.
Recommended CitationAshkenazi, Avi and Silberstein, Stephen, "Botulinum toxin and other new approaches to migraine therapy" (2004). Department of Neurology Faculty Papers. Paper 11.