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Nervenheilkunde 2019; 38(10): 740-744
DOI: 10.1055/a-0997-1229
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Tops und Flops der Kopfschmerztherapie

Tops and flops in headache treatment
Hans-Christoph Diener
1   Medizinische Fakultät der Universität, Duisburg-Essen, Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen
,
Volker Limmroth∗
2   Neurologische Klinik, Kliniken der Stadt Köln, Krankenhaus Merheim
,
Charly Gaul∗
3   Migräne- und Kopfschmerzklinik Königstein, Königstein im Taunus
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2019 (online)

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ZUSAMMENFASSUNG

Die Therapie akuter Migräneattacken und die Prophylaxe der Migräne wurde durch Fortschritte in den Erkenntnissen der Pathophysiologie der Migräne und die Entwicklung neuer Substanzklassen in den letzten 30 Jahren dramatisch verbessert. Dazu gehört die Einführung der Triptane. Antagonisten gegen Substanz-P waren allerdings nicht wirksam. In der Migräneprophylaxe waren neben den etablierten Medikamenten auch Topiramat und bei der chronischen Migräne Onabotulinumtoxin A wirksam. Neue Ansätze ergeben sich durch die neuen monoklonalen Antikörper gegen CGRP oder den CGRP-Rezeptor. Wichtige Fortschritte gab es in der Epidemiologie und Therapie des chronischen Kopfschmerzes durch Übergebrauch von Schmerz- oder Migränemittel. Patienten mit diesem Krankheitsbild sollten bevorzugt in Schwerpunktpraxen oder Kopfschmerzzentren behandelt werden.

ABSTRACT

The therapy of acute migraine attacks and the prophylaxis of migraine have been dramatically improved by advances in the understanding of the pathophysiology of migraine and the development of new classes of substances over the last 30 years. This includes the introduction of triptans. However, antagonists against substance P were not effective. In migraine prophylaxis, in addition to the established drugs, topiramate and onabotulinum toxinA were also effective in chronic migraine. New approaches are emerging from the new monoclonal antibodies against CGRP or the CGRP receptor. Important progress has been made in the epidemiology and treatment of medication overuse headache. Patients with medication overuse headache should be treated preferentially in specialist practices or headache centres

Schlüsselwörter

Triptane - Substanz-P-Antagonisten - CGRP - Kopfschmerzzentren

Key words

Triptans - substance P antagonists - CGRP - headache centres
 

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