Although numerous treatments for migraine
have been advocated throughout history, the preventive
management of migraine can be seen as originating
from the development of methysergide in the
1960s. Synthesized from lysergic acid, methysergide
proved to be a potent and selective inhibitor of the
actions of serotonin.1 Clinically, it was effective as a
migraine preventive and was approved in 1962 by the
US Food and Drug Administration (FDA) for this
purpose. Subsequently, it was recognized that with chronic use, methysergide could cause fibrotic complications,
especially retroperitoneal fibrosis, and it
has since been removed from the market in the
United States. For that period of time during which
it was used, however, it created a paradigm shift in
thinking about migraine management. This was
described by Neil Raskin, a headache specialist
working at the time: “It was quite astonishing how
this drug changed physicians’ thinking about the
nature of migraine. This drug’s ability to antagonize
certain actions of serotonin abruptly transformed
migraine from a psychosocial problem to a scientific
one. It was the first of the stabilizers that could actually
affect the mechanism in such a way that symptoms
did not reappear. It didn’t simply suppress
symptoms but actually reset the mechanism so that
patients could go about their lives and forget about
headaches.
Although numerous treatments for migraine
have been advocated throughout history, the preventive
management of migraine can be seen as originating
from the development of methysergide in the
1960s. Synthesized from lysergic acid, methysergide
proved to be a potent and selective inhibitor of the
actions of serotonin.1 Clinically, it was effective as a
migraine preventive and was approved in 1962 by the
US Food and Drug Administration (FDA) for this
purpose. Subsequently, it was recognized that with chronic use, methysergide could cause fibrotic complications,
especially retroperitoneal fibrosis, and it
has since been removed from the market in the
United States. For that period of time during which
it was used, however, it created a paradigm shift in
thinking about migraine management. This was
described by Neil Raskin, a headache specialist
working at the time: “It was quite astonishing how
this drug changed physicians’ thinking about the
nature of migraine. This drug’s ability to antagonize
certain actions of serotonin abruptly transformed
migraine from a psychosocial problem to a scientific
one. It was the first of the stabilizers that could actually
affect the mechanism in such a way that symptoms
did not reappear. It didn’t simply suppress
symptoms but actually reset the mechanism so that
patients could go about their lives and forget about
headaches.
การแปล กรุณารอสักครู่..