Headache

Question 1

Receptor target of triptans

Answer 1

Agonists at 5HT-1B and 5HT-1D

Question 2

What is the mainstay of cluster headache prophylactic treatment?

What can be added to this?

What is another potential first-line med?

Answer 2

Mainstay: verapamil

Adjuncts: Lithium, TPM, ?melatonin, ?VPA.

Alternate first-line: Galcanizumab (Emgality) 300

Question 3

Genetic causes of familial hemiplegic migraine (3)

Answer 3

1. CACNA1A (P/Q Ca channel)
2. ATP1A2 (A1A1 NKA)
3. SCN1A (Na channel)

Question 4

What medications can be used for hypnic headache?

Answer 4

Lithium, indomethacin, caffeine, melatonin - none w great evidence