Dr. Rogawski also presented research from his own laboratory, where he identified GluK1 kainate receptors as targets for topiramate, a drug with antiepileptic and antimigraine properties. He proposed that topiramate may be effective in migraine prophylaxis by blocking GluK1 kainate receptors, which are known to be present in trigeminal neurons that mediate migraine pain mechanisms.
“Many of the antiepileptic drugs actually have significant use in migraine,” he noted. “Topiramate is probably used for migraine prophylaxis more frequently than it’s used in epilepsy.”
Antiepileptic Drugs Are Effective in Migraine Treatment
“Although epilepsy and migraine have many similarities, it is important to distinguish between the two conditions to guide therapy,” Dr. Rogawski stated. “Occipital epilepsy with visual symptoms responds to antiepileptic drugs but not to the acute antimigraine agents that are useful in migraine with visual aura.” He noted that some antiepileptic drugs, including divalproex sodium, topiramate, and gabapentin, are useful in migraine prophylaxis.
“Molecular targets that were originally studied because of antiepileptic drug development continue to have potential as targets for the development of migraine drugs—particularly compounds that interact with the NMDA receptors. GluK1 kainate receptors are also a promising new target,” he said.
“I hope that we spend a lot more time talking together—the epilepsy community and the headache community,” Dr. Rogawski concluded. “The work we do in the development of therapies for epilepsy has the potential to impact migraine. We have already had that happen, and I think in the future it will happen again.”
—Ariel Jones