Migraine treatment improved considerably with the advent of the 'triptans' in the 1990s. While the drugs used previously for headache treatment had efficacy, some compounds had bothersome side effects and their overuse could lead to severe complications. In the early days of the triptans, it was widely presumed that migraine was no longer a treatment problem. However, it has gradually been recognized that a significant proportion of patients are not responsive to triptans or do not tolerate them. It is now clear that, even with effective treatment, patients with frequent migraine attacks are not treated well exclusively with acute medications. This is partly because patients are still bothered by the attacks and partly because frequent intake of acute medication may result in medication-overuse headache. These problems have led to a renewed interest in preventive migraine drugs.
Part of the Frontiers in Headache Research series, this book summarizes the several promising new avenues for the development of future drugs for the treatment of migraine, including cortical-spreading depression inhibition, nitric oxide synthase inhibition and calcitonin gene-related peptide (CGRP) receptor antagonism, as well as other potential targets. The book presents frontline knowledge of these evolving modalities as far as it is available in the public domain. It is hoped that readers and their patients will find it exciting to learn about all the novel possibilities, and also that the impressive research advances in migraine will lead to increased funding, not only of migraine but also of other types of headache.

Headache medicine research is a rapidly expanding discipline and many important advances in headache management have developed over the last 20 years. However, the revolution and evolution in headache medicine has remained limited largely to the developed countries. Indeed, there is an enormous need for further quality and capacity of headache care in most parts of the world. Thankfully, efforts to bridge this gap have begun. To date, training of practitioners in headache medicine is improving in the developing countries, country-specific epidemiological research is increasing, and new therapies are trickling slowly to the developing world.
Part of the Frontiers in Headache Research series, this book brings the theme of a global campaign to the forefront. Researchers, scientists, and respected clinicians from around the world discuss aspects of access to care, individual and societal burden, and public health authorities address the problems of headache medicine as public health issues to hundreds of millions of headache sufferers worldwide.