Physicians may soon have the option of a new treatment for migraine. Oral lasmiditan has been approved by the US FDA for the acute (active but short-term) treatment of migraine with or without aura in adults. It is not indicated for preventive treatment of migraine. It will be available in doses of 50 mg, 100 mg and 200 mg.

Lasmiditan is a serotonin agonist, which targets the 5-HT1F receptor. It supposedly exerts its beneficial effect by terminating migraine in the brain stem and preventing processing of the migraine centrally.

The effectiveness of lasmiditan has been demonstrated in two randomized, double-blind, placebo-controlled trials involving more than 3000 adult patients with a history of migraine with and without aura. More patients treated with lasmiditan reported relief from pain as well as associated symptom (nausea, light sensitivity, or sound sensitivity) two hours after treatment compared to those who received placebo. Although patients were allowed to take a rescue medication 2 hours after lasmiditan was given, opioids, barbiturates, triptans, and ergots were not allowed within 24 hours of taking the drug

Side effects: Dizziness, fatigue, paresthesia, sedation

Precautions

• Patients should be advised not to drive or operate machinery for at least eight hours after taking. Patients who cannot follow this advice should be advised not to take lasmiditan.
• Use with caution if taken along with alcohol or other CNS depressant drugs.

Dr KK Aggarwal

Padma Shri Awardee

President Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA