Conflict of Interest: Consultant for NuPathe Inc, ProStraken, Inc, Evoke Pharma, GSK, Tranzyme Pharmaceuticals, Rhythm, Inc.
Migraine and Gastroparesis From a Gastroenterologist's Perspective
Article first published online: 30 MAY 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Special Issue: Migraine and Gastrointestinal Manifestations – Treatment Challenges
Volume 53, Issue Supplement S1, pages 4–10, June 2013
How to Cite
Parkman, H. P. (2013), Migraine and Gastroparesis From a Gastroenterologist's Perspective. Headache: The Journal of Head and Face Pain, 53: 4–10. doi: 10.1111/head.12112
- Issue published online: 30 MAY 2013
- Article first published online: 30 MAY 2013
- Manuscript Accepted: 5 MAR 2013
- NuPathe Inc
- 5-hydroxytryptamine1B/1D agonist;
Gastroparesis is a chronic stomach disorder manifested by delayed emptying of solids and liquids without evidence of mechanical obstruction. Evidence from pharmacokinetic and gastric motor studies conducted over the past 40 years shows that delayed gastric emptying often occurs in migraine. This paper provides a general overview of gastroparesis for the headache specialist, discusses the research on the association of gastroparesis and migraine, and considers the clinical implications of that association. The nature, causes, correlates, and consequences of gastric stasis in migraine are just beginning to be elucidated; much further study is warranted. The data available to date show that gastric stasis in migraine appears to be clinically important. Evidence from both pharmacokinetic studies and studies measuring gastric motor function suggests that gastric stasis may delay absorption of an orally administered drug, delay its peak serum concentrations, and delay its effectiveness. These results suggest that oral migraine medications, which rely on absorption from the gastrointestinal tract, may be affected in the presence of migraine-associated gastric stasis. Several non-oral formulations that do not rely on gastrointestinal absorption are available or in development for the treatment of migraine and symptoms of gastroparesis.