Migraine was long a medical mystery. Millions of people suffered – often in silence, and frequently misunderstood. As migraine sufferers know all too well, it often comes on suddenly, with full force. The day starts off normally, but a just few hours later the head is pounding and throbbing. What sounds like a “severe headache” to outsiders is a serious neurological crisis for those affected.

A glimpse into the past – from myths to molecules

The oldest texts describing migraine-like symptoms go back to 3,000 BCE.
In old Europe, it was long believed that migraine was caused by “rising vapors” in the brain. The thinking slowly began to change in the 17th century. British doctor Thomas Willis recognized that migraine probably had something to do with the blood vessels – a decisive step towards modern therapeutic approaches.

An illness with serious consequences

Today, migraine is recognized as one of the most common neurological disorders worldwide. Around one million people in Switzerland – roughly one in seven to ten people – suffer from it. Women are three times more likely to be affected than men¹. Despite its prevalence, migraine was neglected as a field of scientific inquiry for decades. It was only in recent times that modern research enabled key advances in understanding the causes of the disease, with positive consequences for treatment and the quality of life of those affected.

A migraine attack is not a “normal” headache. It is an expression of highly sensitive stimulus processing in the brain. Around a quarter of patients also experience what is known as an aura, which is characterized by visual disturbances, numbness, speech problems or dizziness. These attacks can last for many hours or even days and completely shut down everyday life. In Europe alone, migraine causes billions of dollars in economic damage every year, mainly through missed work and lost productivity³.

New insights through modern research

Migraine was long regarded as a purely vascular disorder – a view that was reflected in the standard therapies of the second half of the 20th century. Earlier medications therefore focused primarily on narrowing the blood vessels. But there was a real breakthrough in the 1980s with the discovery of what is known as the trigeminovascular system. Researchers discovered that a nerve plexus in the brain interacts closely with the blood vessels of the meninges⁴.

At the heart of this network is a neurotransmitter that is released during a migraine attack and triggers an inflammatory response in the brain tissue. This central mechanism is now considered the main cause of typical migraine pain⁵. This new insight not only changed research, but also revolutionized therapy.

Drugs with a targeted effect

These findings made it possible to develop a drug therapy that specifically intervenes in the biological processes of migraine. Triptans came onto the market in the 1990s. They inhibit the release of the neurotransmitter while at the same time constricting the dilated blood vessels. Many patients benefited from this new group of medications. Triptans proved not to be suitable for everyone, however. There are limitations for people with cardiovascular diseases⁶ in particular.

Researchers therefore sought alternative mechanisms of action, which led to the development of gepants. Gepants block receptors directly and have an anti-inflammatory effect without the vascular constriction. They are regarded as well tolerated and can also be used for prevention⁷.

Antibody therapy marked another milestone. It enables a long-term reduction in the frequency of migraine attacks; in many cases, one injection per month is sufficient. Clinical studies have shown significant improvements in the quality of life of people with chronic migraine⁸.

Innovations on the horizon – what the future holds

Research into migraine continues apace. Work is now underway on personalized therapeutic approaches that are tailored to the genetic characteristics of the individual patients. The aim is not only to provide better treatment, but also to precisely tailor the therapies⁹. New non-drug approaches are also being developed, including therapies in which electric or magnetic impulses target regions of the brain that are involved in the development of migraines¹⁰.

Even the color of light is being studied. Initial clinical studies indicate that a green light can reduce the intensity of migraine pain in some patients¹¹. Digital technologies are also increasingly being used in treatment, with migraine apps that document attacks and analyze progression patterns, thus helping to better recognize individual triggers and adapt therapies¹².

Research changes lives

The history of migraine is an impressive example of how medical research leads to real progress. What was a mystery for centuries is now understood – and treated effectively. Millions of people benefit from targeted, modern medicines, improved diagnostic procedures and a new medical understanding of the disease. This transformation is the result of decades of research. Interpharma is dedicated to ensuring that this path of advancement continues. After all, progress requires scientific curiosity and a clear vision: the mission of treating migraines effectively. We keep researching.

¹ Federal Office of Public Health (FOPH). Swiss headache and migraine statistics.
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⁴ Goadsby PJ et al. Pathophysiology of migraine: a disorder of sensory processing. Physiological Reviews. 2017;97(2):553–622.
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⁸ Tepper S et al. Efficacy and safety of erenumab for preventive treatment of chronic migraine. Lancet Neurology. 2017;16(6):425–34.
⁹ Borsook D et al. Personalized medicine for migraine: an evolving landscape. Headache. 2021;61(5):725–35.
¹⁰ Chou DE et al. Noninvasive neuromodulation for migraine. JAMA Neurology. 2017;74(5):571–6.
¹¹ Noseda R et al. A human fMRI study on green light and photophobia. Brain. 2016;139(Pt 7):1971–80.
¹² Schwedt TJ et al. Use of smartphone technology in the management of migraine. Headache. 2019;59(6):802–16.