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Lasmiditan for the treatment of acute migraine: a review and potential role in clinical practice

Authors Oswald JC, Schuster NM

Received 12 April 2018

Accepted for publication 7 August 2018

Published 8 October 2018 Volume 2018:11 Pages 2221—2227

DOI https://doi.org/10.2147/JPR.S152216

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval


Jessica C Oswald, Nathaniel M Schuster

UCSD Center for Pain Medicine, La Jolla, CA, USA

Abstract: Now that the vascular hypothesis of migraine is no longer the prevailing theory of migraine pathogenesis, there is interest in developing acute migraine treatments that act exclusively on non-vascular targets. There is a large percentage of non-responders to current acute migraine treatments and the vasoconstriction associated with triptans limit their use in patients with pre-existing cardiovascular risk factors. Preferential 5-HT1F agonists have shown promising results in in vitro and early proof-of-concept trials. Lasmiditan, a highly selective 5-HT1F agonist, has completed two Phase III randomized, double blind, placebo-controlled clinical trials, with a third – a long-term, open-label safety study – still underway. Research to date suggests lasmiditan lacks vasoconstrictive properties and may be a safe and effective treatment option in patients refractory to current acute migraine medications or who have cardiovascular risk factors.

Keywords: lasmiditan, 5HT-1F, migraine, headache, serotonin

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