One of the most encouraging aspects of current migraine therapy is that there is always room for improvement. New medications are constantly being studied and tested. The cream of the crop will eventually be available for the general public, but in the meantime, here is a preview of some medications that one day may make an appearance at a pharmacy near you.

MK-0974

A new medication, currently called MK-0974, has been wowing researchers. This is a different class of drug from the triptans that many migraine sufferers take, but it has the possibility of working for those who cannot tolerate triptans. The idea behind MK-0974 is that it inhibits the release of calcitonin gene-related peptide (CGRP), which is a protein that is released during inflammation; migraineurs are often seen to have high levels of this protein.

One advantage of this drug is that it would be safer for patients with heart disease because it does not make blood vessels constrict. Early studies show the possibility of MK-0974 success in patients who, for any number of reasons, are unable to achieve relief from triptans. Early reports indicate that as many as 65 percent of people who try MK-0974 report decreased migraine pain. This drug needs further testing before it can be made available to the general public, but watch for news about it in the next few years.

Botox

Botox has been in the news in recent years for its ability to temporarily reduce the appearance of facial wrinkles. However, new research shows that it may also be valuable as a treatment for migraine. Botulinum toxin type A, or Botox (BTX-A), is a toxin that is most commonly injected into muscles to cause a decrease in muscle activity. However, studies show that when injected into the upper portion of the face, Botox has the potential to reduce the incidence of migraine for up to six months.

While the discovery of Botox's applicability to migraine was accidental, researchers seized on this information and began looking for confirmation. As yet, Botox is not an FDA-approved treatment for migraine. For this reason, the treatment is not covered by most insurance policies. See Chapter 8 for more information on botulism A as a migraine preventative.

Trexima

Another new medication that has the potential to relieve migraine pain is called Trexima. This is a combination therapy, one that combines Imitrex with naproxen sodium. Naproxen sodium is a nonsteroidal anti-inflammatory drug; the version available over the counter in the United States is called Aleve. Trexima is currently under FDA review, and has shown positive results in reducing migraine pain.

Alternate Delivery

Many child migraine sufferers, and some adults, have difficult swallowing tablets. In addition, the nausea and vomiting that often accompanies a migraine attack can make keeping down medication a challenge.

Some newer versions of migraine medications are available in nasal spray form, and these have the potential to make abortive drugs more widely accepted and easier to tolerate. One example is Sumatriptan nasal spray, which comes with a simple delivery mechanism that is both effective and child-friendly. Nasal sprays are fast acting and ensure that the maximum dose can be absorbed.

There are also new needle-free injection systems coming down the pipeline, including Intraject. This system features subcutaneous injections that are painless and easy. Lingual spray systems for Sumatriptan are also being developed, as are meltable tablets and sustained-release patches.