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Cutaneous allodynia and migraine: another view.

Journal article
Authors Carl Dahlöf
Published in Current pain and headache reports
Volume 10
Issue 3
Pages 231-8
ISSN 1531-3433
Publication year 2006
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 231-8
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Humans, Hyperalgesia, drug therapy, physiopathology, Migraine Disorders, drug therapy, physiopathology, Serotonin Agonists, pharmacokinetics, therapeutic use, Sumatriptan, pharmacokinetics, therapeutic use
Subject categories Medical and Health Sciences

Abstract

The paradigm of early treatment of the migraine attack at mild pain intensity has become one alternative to circumventing the problem of compromised oral absorption of symptomatic drugs due to migraine-induced gastrointestinal dysmotility. Early treatment also has been proposed to be advantageous because most migraineurs could be less responsive to delayed treatment, owing to the development of central sensitization of the trigeminal pain transmission. Ranking the underlying principles, it seems that the improved response to an oral triptan formulation at mild migraine symptom intensity has more to do with less impaired gastrointestinal absorption in the early stage of the attack than decreasing the time and preventing chances for central sensitization and development of cutaneous allodynia. Furthermore, parenteral administration of a triptan is always more likely to provide relief of symptoms than conventional tablets, even when it is used later in the course of the migraine attack. Individually tailored use of the available triptan formulations will increase, without any doubt, the within-migraineur consistency of response. It also will reduce the overall proportion of migraine attacks or migraineurs not responding to triptan treatment. Notwithstanding, the recommendation of early treatment during the migraine attack when the pain is mild remains valid.

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